Back
Living-donor kidney transplantation has become the treatment of choice for the majority of patients with end-stage kidney disease. Substantial improvements in transplant immunology and the availability of novel immunosuppressive regimens have allowed more attention to be paid to nonimmunologic factors influencing post-transplant outcomes, such as donor kidney function. There is evidence that kidney volume may determine the number of nephrons and may indirectly correlate with kidney function. So, pre-donation kidney volume may be a crucial factor in determining graft outcomes in kidney transplant recipients. This study aimed to study the relationship between living-donor kidney volume and recipient body weight ratio on the outcome of kidney transplant recipient patients.
A hospital-based prospective longitudinal study done in No.(1) Defence Services General Hospital(1000-Bedded), No.(2) Defence Services General Hospital(1000-Bedded), No.(1) Military Hospital(700-Bedded) and No.(2) Military Hospital(700-Bedded) from October 2020 to March 2022. Total live-related 46 renal transplant pairs were included. Pre-transplant donor renal volumes were calculated from computerized tomography (CT) renal angiogram scans using the ellipsoid formula. Pre-transplant recipient body weights such as dry weight of the last haemodialysis before transplantation were documented. Renal allograft function was assessed by using the CKD-MDRD formula to eGFR at the hospital discharge, 3rd month, and 6th month.
The DKV/RW ratio, the large ratio (≥2.5cc/Kg) group was 18 pairs (39.1%) and the low ratio (<2.5cc/Kg) group was 28 pairs (60.9%). The mean DKV/RW ratio was 2.46 ± 0.68 and ranged from 1.5-4.1cc/Kg. A comparison of eGFR between two DKV/RW ratio groups is presented as follows; at discharge from the hospital after transplantation, the mean eGFR ± SD values were 67.37 ± 18.69 for DKV/RW ratio < 2.5 cc/Kg group and 76.25 ± 25.32 for DKV/RW ratio ≥ 2.5 cc/Kg group. In 3rd month after transplantation, the mean eGFR ± SD values were 77.26 ± 20.17 and 87.83 ± 26.86 for the two groups respectively. In 6th month after transplantation, the mean eGFR ± SD values for the two groups were 93.04 ± 22.69 and 99.28 ± 25.35 respectively. Among these differences were statistically not significant. Pearson’s correlation was used to detect a relationship between donor kidney volume and recipient body weight (DKV/RW) ratio and recipient renal graft function in the 6th month but there was no significant association was found, [r = 0.205, p = 0.178].
The living-donor kidney volume to recipient dry weight (DKV/RW) ratio had statistically no significant association with eGFR on the outcome of renal transplant recipient patients. The living-donor kidney volume to recipient body weight (DKV/RW) ratio is one of the non-immunological risk factors for allograft outcomes. But this present study was a short-term study and long-term allograft survival of all these patients should be monitored and followed.