Clinical Implications for Graft Function of a New Equation Model for the Ratio of Living Donor Kidney Volume to Recipient Body Surface Area
이창기, 윤영은, 최경화, 양승철, 이중식, 주동진, 허규하, 김유선, 한웅규,
소속 상세정보
이창기 ( Lee Chang-Ki )
Yonsei University Health System Urological Science Institute Department of Urology
윤영은 ( Yoon Young-Eun )
Yonsei University Health System Urological Science Institute Department of Urology
최경화 ( Choi Kyung-Hwa )
Yonsei University Health System Urological Science Institute Department of Urology
양승철 ( Yang Seung-Choul )
Yonsei University Health System Urological Science Institute Department of Urology
이중식 ( Lee Joong-Shik )
Kwandong University College of Medicine Cheil General Hospital & Womens Healthcare Center Department of Urology
주동진 ( Joo Dong-Jin )
Yonsei University Health System Department of Surgery
허규하 ( Huh Kyu-Ha )
Yonsei University Health System Department of Surgery
김유선 ( Kim Yu-Seun )
Yonsei University Health System Department of Surgery
한웅규 ( Han Woong-Kyu )
Yonsei University Health System Urological Science Institute Department of Urology
KMID : 0358320130540120870
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.
키워드
Delayed graft function; Kidney; Living donors; Organ size; Transplantation
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