Purpose@#This study evaluated the
role of
donor kidney ultrasonography (US) for predicting functional
kidney volume and identifying ideal
kidney grafts in deceased
donor kidney transplantation. @*
Methods@#In total, 272
patients who underwent deceased
donor kidney transplantation from 2000 to 2020 at Samsung Medical Center were enrolled.
Donor kidney information (i.e., right or left) was provided to the
radiologist who performed US image re-
analysis. To binarize each
kidney’s ultrasound
parameters, an optimal cutoff value for estimated
glomerular filtration rate (eGFR) of less than 30 mL/min/1.73 m2 within 1 year after
kidney transplantation was selected using the
receiver operating characteristic curve with a
specificity >60%. Cox
regression analysis was performed for an eGFR less than 30 mL/min/1.73 m2 within 1 year after
kidney transplantation and
graft failure within 2 years after
kidney transplantation. @*Results@#The product of renal length and cortical thickness was a statistically significant predictor of
graft function. The
odds ratios of an eGFR less than 30 mL/min/1.73 m2 within a year after
kidney transplantation and the
hazard ratio of
graft failure within 2 years after
kidney transplantation were 5.91 (P=0.003) and 5.76 (P=0.022), respectively. @*Conclusion@#Preoperative US of the
donor kidney can be used to evaluate
donor kidney function and can predict short-term
graft survival. An imaging modality such as US should be included in the
donor selection criteria as an additional recommendation. However, the purpose of this study was not to narrow the expanded criteria but to avoid catastrophic consequences by identifying ideal
donor kidneys using preoperative US.