Korean J Urol.  2013 Dec;54(12):870-875.

Clinical Implications for Graft Function of a New Equation Model for the Ratio of Living Donor Kidney Volume to Recipient Body Surface Area

• Lee CK
• Yoon YE
• Choi KH
• Yang SC
• Lee JS
• Joo DJ
• Huh KH
• Kim YS
• Han WK

Abstract

PURPOSE
We propose an equation that predicts graft function after kidney transplantation by using donated kidney volume and recipient body surface area (BSA).
MATERIALS AND METHODS
Included were 261 cases of living kidney transplantation between 2007 and 2009. Preoperative computed tomography scans were performed and the donated kidney volume was measured by use of a three-dimensional reconstruction program (Ripidia). The estimated glomerular filtration rate (eGFR) was calculated by using the modification of diet in renal disease formula. Donated kidney volume, preoperative renal function, and demographic factors of both donors and recipients were evaluated as predictors.
RESULTS
The mean ages of the donors and recipients were 40.8 and 41.6 years, respectively. The mean donated kidney volume and donated kidney volume/recipient BSA ratio were 153.4 mL and 96.9 mL/m2, respectively. Mean preoperative and postoperative 12-month eGFR of recipients were 7.1 and 59.7 mL/min, respectively, and the mean preoperative eGFR of donors was 92.2 mL/min. Donated kidney volume/recipient BSA ratio, donor age, and recipient gender were the significant predictors of eGFR level (p<0.001) and eGFR<45 mL/min at postoperative 12 months (p=0.005, p<0.001, and p=0.006). From the multiple linear regression equation and predicted probability from logistic regression, we could calculate the equation for the ratio of living donor kidney volume to recipient BSA on graft function.
CONCLUSIONS
Graft kidney volume/recipient BSA ratio, donor age, and recipient gender were predictors of graft function 12 months after kidney transplantation. Although we are concerned only with the preoperative, this equation model could help physicians to counsel patients concerning their postoperative prognosis and to avoid insufficient volume donations.

Keyword

Delayed graft function; Kidney; Living donors; Organ size; Transplantation

MeSH Terms

Body Surface Area*
Delayed Graft Function
Demography
Diet
Glomerular Filtration Rate
Humans
Kidney Transplantation
Kidney*
Linear Models
Living Donors*
Logistic Models
Organ Size
Prognosis
Tissue Donors
Transplantation
Transplants*

Figure

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  FIG. 1 A parenchymal boundary in the sliced image used in calculating total kidney volume.

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  FIG. 2 Receiver operator characteristic (ROC) curve for predictive equation for 12-month graft function.

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