Ratio of Kidney Weight to Recipient Weight Correlates with the 3-Year Graft Function / 대한이식학회지

Reduced renal mass, increased recipient body size, and their mismatching are the potential risk factor to explain the non-immunologic graft dysfunction. Present study was designed to assess the effect of mismatch between donor kidney weight (KW) and recipient body weight (BW) on the 3-year graft function in live donor renal transplantation (TX) patients (pts) who were operated before Nov. 1995 under cyclosporine. To remove immunologic injuries and effect of glomerulonephritis (GN), the pts experiencing episode of acute rejection or showing post-TX biopsy-proven GNs were excluded. A total of 82 pts cohort was identified and followed up till Nov. 1998. The donor KW after cold flushing, BW of recipient at TX, and renal parameters at 3-year post-TX such as serum creatinine (Scr), creatinine clearance ratio (CCR) and 24-hour urinary excretion of protein (24UP) were recorded. First, any correlation between the index value of the KW/BW ratio and each parameters was studied by the regression analysis, and secondly, the pts were stratified into 3 groups by the KW/BW ratio (3.5 4.0) and compared with each parameters by ANOVA test. Scr, CCR, and 24 UP was well correlated with the ratio KW/BW (p4.0) have significantly lower Scr, higher CCR and lower 24 UP compared with pts showing medium or low ratio. In conclusion, the mismatch between the donor KW and recipient BW has a substantial effect on the medium term graft function. Since estimating the kidney volume by CT scan or ex vivo after bench surgery is simple and easily applicable in clinical practice, KW/BW ratio is to be considered for the selection or allocation of potential donor in both cadaveric and living donor TX programs.

Influence of the True Living Donor Kidney-Weight to Recipient Body-Weight Ratio on the Post-Transplant 1 Year Renal Allograft Function

The importance of the donor-to-recipient body surface area ratio or the calculated donor kidney-weight to recipient body-weight ratio is still matter of controversy in clinical renal transplantation(Tx). To assess the value of the true kidney weight(KW in gms) to the recipient body-weight(BW in kg) ratio in living donor renal Tx, the records of 165 adult living donor renal transplants were reviewed. All patients received uniform cyclosporine and steroid immunosuppression. Five patients were excluded because of early graft loss. In the remaining 160 patients, full information including KW, BW, degree of HLA matching, demographics of recipient and donor, acute rejection(AR) episodes, serum creatinine(Scr) at post-Tx 1 month and 1 year, 24 hours urinary excretion of protein at post-Tx 1 year and finally outcome of graft were available. Patients with KW/BW3.5, but this difference was not statistically significant. These findings were still true even if we eliminated the effect of acute rejection episodes. In 96 patients that never experienced acute rejection, we could demonstrate the significant impact of KW/BW on the Scr. In conclusion, if the Scr at post-Tx 1 year is a major determinant of the long-term graft outcome, the important role of KW/BW ratio is must considered in the selection of a potential living donor.

Influence of the True Living Donor Kidney-Weight to Recipient Body-Weight Ratio on the Post-Transplant 1 Year Renal Allograft Function

The importance of the donor-to-recipient body surface area ratio or the calculated donor kidney-weight to recipient body-weight ratio is still matter of controversy in clinical renal transplantation(Tx). To assess the value of the true kidney weight(KW in gms) to the recipient body-weight(BW in kg) ratio in living donor renal Tx, the records of 165 adult living donor renal transplants were reviewed. All patients received uniform cyclosporine and steroid immunosuppression. Five patients were excluded because of early graft loss. In the remaining 160 patients, full information including KW, BW, degree of HLA matching, demographics of recipient and donor, acute rejection(AR) episodes, serum creatinine(Scr) at post-Tx 1 month and 1 year, 24 hours urinary excretion of protein at post-Tx 1 year and finally outcome of graft were available. Patients with KW/BW3.5, but this difference was not statistically significant. These findings were still true even if we eliminated the effect of acute rejection episodes. In 96 patients that never experienced acute rejection, we could demonstrate the significant impact of KW/BW on the Scr. In conclusion, if the Scr at post-Tx 1 year is a major determinant of the long-term graft outcome, the important role of KW/BW ratio is must considered in the selection of a potential living donor.