Is the Graft Function of Living Donor Renal Transplants Associated With Renal Mass Matching by Computed Tomography Angiographic Volumetry?

Abstract

Background. Donor renal volume, which can be easily measured by computerized tomographic angiography with 3-dimensional reconstruction, may influence graft outcomes. Low functional renal mass and donor kidney-recipient body size mismatch can lead to progressive renal injury and poor graft function. Materials and methods. This single-center retrospective analysis of 51 consecutive living donor renal transplantations performed between January 2005 and December 2011 defined transplant renal volume per unit recipient body surface area (BSA; mL/m(2)). The patients were divided into 2 groups: group I (n = 31, donor-recipient BSA ratio <= 1) and group II (n = 20, BSA ratio >1). We analyzed the clinical characteristics and laboratory data of donors and recipients to ascertain correlations with, renal volumes and graft outcomes. Results. The renal volumes of living donors correlated with estimated glomerular filtration ratios (eGFR; r = .314, P = .025). Serum creatinine after renal transplantation correlated with transplanted renal volume at 1, 3, and 12 months (r = -.319, P = .048; r = -.407, P = .010; r = -.472, P = .002). Serum eGFR also correlated with transplanted renal volume at 3 and 12 months after renal transplantation (r = .318, P = .049 and r = .388, P = .015). There were no significant differences between groups for acute or chronic rejection, infection or delayed graft function. However, serum creatinine levels were higher (P = .011, P = .022, and P = .007) and serum eGFR significantly lower in group I at 1, 3, 6, and 12 months after renal transplantation (P = .036, P = .042, P = .042, and P = .049, respectively). There was no significant difference in graft survival. Conclusions. Renal volume of living donors may reflect renal function and have a significant impact on graft outcomes. Renal volume matching should be considered to select donor-recipient pairs for living donor renal transplantation.