Abstract: SA-PO101
Nephron Dose Does Not Predict Renal Function After Live Donor Renal Transplantation
Session Information
- Transplantation: Recipient and Donor Assessment
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1801 Transplantation: Basic
Authors
- Goorachan, Steven, St. James Hospital, Leeds, United Kingdom
- Youngs, Rachel Jayne, SJUH, Leeds, United Kingdom
- Baker, Richard James, SJUH, Leeds, United Kingdom
Background
In our live donor transplant programme we consider isotopic determinations of donor glomerular filtration rate (GFR) as an indicator of the donor kidney quality. We also measure isotopic split renal function and thus by multiplying the two together we can calculate the potential “nephron dose” of the transplant. This has been used anecdotally as a guide to the quality of the graft and to inform the likely outcome in terms of function. This consideration has recently become more pertinent with the expansion of the national live donor sharing scheme since multiple potential donors may be considered for any particular recipient.
Methods
We recorded 147 patients from August 2008 to August 2017 excluding: those without follow up data; paediatric patients; and those with early graft loss (< year). Data set included estimated and measured GFR, split function of kidneys, Recipient body surface area (BSA), and recipient eGFR (MDRD equation) at 3, 6 and 12 months post transplant. We determined Nephron Dose using the formula: Measured isotopic GFR x percentage function of donated kidney = Nephron dose. We also measured the recipient’s eGFR post transplant at t=3, 6 and 12 months, and corrected these measurements to recipients BSA. We measured the strength of the association using correlation coefficients.
Results
We report that the was no clear correlation with nephron dose to renal function at 3, 6 or 12 months whether eGFR was corrected for recipient body surface area or not, (table).
Conclusion
Nephron dose was not found to be strongly correlated with recipient transplant function at 3, 6 or 12 months following live donor renal transplants. This may represent inaccuracy of either isotopic studies in donors to determine renal function or the MDRD formula to estimate true GFR post renal transplant. However we propose that postoperative transplant function is determined by a complex interplay between several factors, many of which are either recipient derived or external (e.g. viral infections and drug toxicity). The weak correlation demonstrated does not support overzealous interpretation of donor functional data even when derived from isotopic studies.
Correlation Coefficients for Nephron Dose and eGFR
| 3 Months | 6 Months | 12 Months | |
| eGFR | 0.355 | 0.320 | 0.342 |
| eGFR Adjusted for BSA | 0.359 | 0.321 | 0.340 |