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

Kim, Yu Seun; Kim, Il Ho; Kim, Myoung Soo; Kim, Soon Il; Moon, Jang Il; Shin, Young On; Kim, Soo Hyon; Park, Ki Il

Abstract

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/BW< OR =3.5 have significantly(p=0.007) higher Scr at post-Tx 1 month and 1 year. The 24 hours urinary excretion of protein in this group was in excess of that for the patients with KW/BW>3.5, 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.