Donor kidney glomerular filtration rate and donor/recipient body surface area ratio influence graft function in living related kidney transplantation

Abstract

Objective: This study seeks to account for the possibility that single kidney glomerular filtration rate (SKGFR) and donor/recipient (D/R) body surface area (BSA) ratio could act as cofactors for evaluating potential living related donors. Methods: The study population included 204 cases of LKRs with a functional graft that were regularly followed up for more than 2 years. Based on SKGFR and D/R BSA ratio, the recipients were divided into six groups: group A (SKGFR < 40 mL/min, D/R BSA ratio ≤ 0.8), group B (SKGFR < 40 mL/min, 0.8 < D/R BSA ratio < 1.2), group C (SKGFR < 40 mL/min, D/R BSA ratio ≥ 1.2), group D (SKGFR ≥ 40 mL/min, D/R BSA ratio ≤ 0.8), group E (SKGFR ≥ 40 mL/min, 0.8 < D/R BSA ratio < 1.2), and group F (SKGFR ≥ 40 mL/min, D/R BSA ratio ≥ 1.2). The database included donor, recipient, and transplant variables. Renal function of the recipients was recorded at 1 week, 2 weeks, 1 month, 3 months, 6 months, 12 months, and 24 months post-transplantation, respectively. Results: The declining rate of SCr and graft eGFR in stable periods post-transplantation in group A were always worse than the other five groups, and the difference was statistically significant (p < 0.05). The declining rate of SCr and graft eGFR in stable periods post-transplantation in groups C and F were always better than the other four groups, and the difference was statistically significant (p < 0.05). Conclusions: Both SKGFR and D/R BSA ratio should be considered for choosing potential living related donors. Donors with SKGFR < 40 mL/min and D/R BSA ratio ≤ 0.8 should be carefully selected. Satisfactory graft function in donors with SKGFR < 40 ml could be achieved if their D/R BSA ratio is >0.8.

• Body surface area
• glomerular filtration rate
• living related kidney recipients

Declaration of interest

The authors have declared no conflict of interest. This study was supported by Chinese Natural Science Foundation (U1204820) and Henan Province Natural Science Foundation Research Project (122300410190).