Introduction:
Kidney transplantation is the best treatment option for patients with end stage kidney disease. In Myanmar, living donor kidney transplant has been done since 1995. There are immunological and non-immunological risks determining the outcome of graft function. Among non-immunological risks, donor kidney weight as well as donor kidney weight to recipient body weight ratio have impact on graft function. This study aimed to determine the effect of donor kidney weight to recipient body weight ratio on graft function at 6 months after transplant in living donor kidney transplant recipient.
Methods:
It was a hospital based prospective study done at Defence Services General Hospital (1000-bedded) Nay Pyi Taw from October 2020 to September 2022. A total of 25 living kidney transplant pairs were included. Donor kidney weight (DKW) in gm (gram) was measured immediately after cold flush and defatting. Recipient’s body weight (RBW), dry weight, in kg (kilogram) was measured ; timing was after the last hemodialysis prior to transplant. The ratio was categorized into ‘High ratio’ ( DKW/RBW ≥ 2.3 g/kg) and ‘Low ratio’ ( DKW/RBW < 2.3 g/kg). Graft function was accessed by serum creatinine, UACR and eGFR. MDRD formula was used to calculate eGFR.
Results:
In ‘High ratio’ group, 100% of recipients had serum creatinine levels of (≤ 1.5 mg/dl) whereas in ‘Low ratio’ group, only 75% had serum creatinine level (≤ 1.5 mg/dl). And the remaining 25% had high serum creatinine level (>1.5 mg/dl). The association between (DKW/RBW) ratio and serum creatinine was statistically significant (p = 0.049). It is demonstrated in Table (1). Table (2) shows the association between DKW/RBW ratio and UACR. In ‘High ratio’ group, UACR level was normal (≤ 300 mg/g) in all recipients. On the contrary, two third of recipients in ‘Low ratio’ group had normal UACR level (≤ 300 mg/g); one third of them had high UACR (>300 mg/g). The association between (DKW/RBW) ratio and UACR was statistically significant (p value = 0.014). In ‘High ratio’ group, 100% of recipients had serum creatinine levels of (≤ 1.5 mg/dl) whereas in ‘Low ratio’ group, only 75% had serum creatinine level (≤ 1.5 mg/dl). And the remaining 25% had high serum creatinine level (>1.5 mg/dl). The association between (DKW/RBW) ratio and serum creatinine was statistically significant (p = 0.049). It is demonstrated in Table (1). Table (2) shows the association between DKW/RBW ratio and UACR. In ‘High ratio’ group, UACR level was normal (≤ 300 mg/g) in all recipients. On the contrary, two third of recipients in ‘Low ratio’ group had normal UACR level (≤ 300 mg/g); one third of them had high UACR (>300 mg/g). The association between (DKW/RBW) ratio and UACR was statistically significant (p value = 0.014).
Table 1. Association between (DKW/RBW) ratio and kidney graft function (serum creatinine)
Table 2. Association between (DKW/RBW) ratio and kidney graft function (UACR)
Conclusions:
The ratio of donor kidney weight to recipient body weight (DKW/RBW) influenced significantly on graft function (serum creatinine and UACR) in living donor kidney transplant recipient. It is likely that the higher the donor kidney weight, the better the graft function.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.