Living Donor Kidney Volume Predictive of Graft Function

Washington, DC—The treatment of choice for patients with end-stage renal disease is kidney transplantation, and living donor kidney transplantation is the optimal model. There are few data available on the prediction value of renal volume measurement in predicting long-term donor and recipient graft outcome.

Chaudhry Adeel Ebad, MBBS, MRCPI, and colleagues at Beaumont Hospital, Dublin, Ireland, conducted a retrospective cohort study of living donor transplantation performed from 2010 to 2017. The researchers utilized data from the National Kidney Transplant Service of Ireland. TeraRecon USA was used to measure renal volume bilaterally in living kidney donors. Results of the study were reported during a poster session at Kidney Week 2019 in a poster titled Donor Kidney Renal Volume Predicts Recipient and Donor Graft Function at 1 Year.

Low estimated glomerular filtration rate (eGFR), defined as <60 mL/min/1.73 m2, in recipients and donors was used in logistic regression models with donor volume stratified into tertiles. The models included donor and recipient characteristics as potential confounding variables.

During the study period, there were 166 living donor kidneys transplanted. Mean donor age was 44.8 years, mean body mass index was 25.5 kg/m2, and mean kidney volume was 152.7 mls. The tertiles of donor kidney volume were: (1) 89.2 to 135 mls; (2) 136 to 164 mls; and (3) 165 to 240 mls. At 1 year post-transplant, median donor estimated glomerular filtration rate (eGFR) was 63.3 mL/min/1.73 m2. Mean age of recipients of living donor kidneys was 43.5 years, and mean recipient eGFR at 1 year post-transplant was 58.3 mL/min/1.73 m2.

There was a slight correlation between donor kidney volume and donor eGFR at 1 year post-transplant; using the kidney volume tertile categories, the correlation was marginally nonsignificant in logistic regression (odds ratio [OR], 0.65; 95% confidence interval [CI], 0,40-1.04; P=.075). There was a correlation between donor kidney volume and recipient eGFR at 1 year post-transplant; the correlation remained significant in multivariable logistic regression (OR, 0.48; 95% CI, 0.26-0.90; P=.021).

In conclusion, the researchers said, “Donor kidney volume predicts recipient graft function 1 year post-transplant but is less conclusive for donor kidney function. Cognizance of donor renal volume may help optimize potential kidney donor selection.”

Source: Ebad CA, Chevarria JL, Sexton DJ, et al. Donor kidney renal volume predicts recipient and donor graft function at 1 year. Abstract of a poster presented during the American Society of Nephrology Kidney Week 2019, November 7, 2019, Washington, DC.