Impact of adjusted kidney volume measured in the bench surgery on one-year renal function in kidney transplantation


Autoři: Flávio Vasconcelos Ordones aff001;  Pedro Ivo Rocchetti Pajolli aff001;  Rodrigo Guerra da Silva aff001;  Hamilto Akihissa Yamamoto aff001;  Fernando Fereira Gomes Filho aff001;  Paulo Roberto Kawano aff001;  João Luiz Amaro aff001;  Luis Gustavo Modelli de Andrade aff006
Působiště autorů: Department of Urology, Botucatu Medical School, São Paulo State University (Universidade Estadual Paulista–UNESP), Botucatu, São Paulo, Brazil aff001;  Urology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia aff002;  BP Hospital, São Paulo, Brazil aff003;  Hospital 9 de Julho, SP, Brazil aff004;  Sirio Libanes Hospital, SP, Brazil aff005;  Department of Internal Medicine, Nephrology, Botucatu Medical School, São Paulo State University (Universidade Estadual Paulista–UNESP), Botucatu, São Paulo, Brazil aff006
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224364

Souhrn

Background

Kidney transplantation is the treatment of choice in patient with end stage chronic kidney disease, offering the best long term survival and greater Quality of Life in this group of patients. Graft volume was correlated with improved renal function in living donor transplantations. The primary aim of this study was to correlate renal volume adjusted to body surface area with renal function one year (estimated glomerular filtration rate; eGFR) after kidney transplantation.

Methods

This single-center, prospective cohort study included 256 patients who underwent kidney transplantation from January 2011 through December 2015 at Hospital das Clínicas de Botucatu–UNESP. We evaluated three kidney measurements during the bench surgery; the final graft volume was calculated using the ellipsoid formula and adjusted to body surface area.

Results

In the living donors there was positive correlation between adjusted graft volume and eGFR (r = 0.311, p = 0.008). Multivariate analysis revealed that low rejection rate and increased adjusted graft volume were independent factors correlated with eGFR. In deceased donors, there was no correlation between adjusted kidney volume and eGFR (r = 0.08, p = 0.279) in univariate analysis, but a multivariate analysis indicated that lower kidney donor profile index (KDPI), absence of rejection and high adjusted kidney volume were independent factors for better eGFR.

Conclusion

Adjusted kidney volume was positively correlated with a satisfactory eGFR at one year after living donor and deceased donor transplantations.

Klíčová slova:

Creatinine – Glomerular filtration rate – Kidneys – Medical dialysis – Renal system – Renal transplantation – Transplant rejection – Transplantation immunology


Zdroje

1. Lugon JR. End-stage renal disease and chronic kidney disease in Brazil. Ethn Dis. 2009;19(1 Suppl 1):S1-7–9.

2. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(2 Suppl 1):S1–266.

3. Schnuelle P, Lorenz D, Trede M, Van Der Woude FJ. Impact of renal cadaveric transplantation on survival in end-stage renal failure: evidence for reduced mortality risk compared with hemodialysis during long-term follow-up. J Am Soc Nephrol. 1998;9(11):2135–41. 9808102

4. Hariharan S, Johnson CP, Bresnahan BA, Taranto SE, McIntosh MJ, Stablein D. Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med. 2000;342(9):605–12. doi: 10.1056/NEJM200003023420901 10699159

5. Port FK, Bragg-Gresham JL, Metzger RA, Dykstra DM, Gillespie BW, Young EW, et al. Donor characteristics associated with reduced graft survival: an approach to expanding the pool of kidney donors. Transplantation. 2002;74(9):1281–6. doi: 10.1097/00007890-200211150-00014 12451266

6. Schold JD, Kaplan B, Baliga RS, Meier-Kriesche HU. The broad spectrum of quality in deceased donor kidneys. Am J Transplant. 2005;5(4 Pt 1):757–65.

7. Azuma H, Nadeau K, Mackenzie HS, Brenner BM, Tilney NL. Nephron mass modulates the hemodynamic, cellular, and molecular response of the rat renal allograft. Transplantation. 1997;63(4):519–28. doi: 10.1097/00007890-199702270-00006 9047144

8. Brenner BM, Milford EL. Nephron underdosing: a programmed cause of chronic renal allograft failure. Am J Kidney Dis. 1993;21(5 Suppl 2):66–72.

9. Giral M, Nguyen JM, Karam G, Kessler M, Hurault de Ligny B, Buchler M, et al. Impact of graft mass on the clinical outcome of kidney transplants. J Am Soc Nephrol. 2005;16(1):261–8. doi: 10.1681/ASN.2004030209 15563571

10. Poggio ED, Hila S, Stephany B, Fatica R, Krishnamurthi V, del Bosque C, et al. Donor kidney volume and outcomes following live donor kidney transplantation. Am J Transplant. 2006;6(3):616–24. doi: 10.1111/j.1600-6143.2005.01225.x 16468974

11. Yano M, Lin MF, Hoffman KA, Vijayan A, Pilgram TK, Narra VR. Renal measurements on CT angiograms: correlation with graft function at living donor renal transplantation. Radiology. 2012;265(1):151–7. doi: 10.1148/radiol.12112338 22798224

12. Juluru K, Rotman JA, Masi P, Spandorfer R, Ceraolo CA, Giambrone AE, et al. Semiautomated CT-Based Quantification of Donor Kidney Volume Applied to a Predictive Model of Outcomes in Renal Transplantation. AJR Am J Roentgenol. 2015;204(5):W566–72. doi: 10.2214/AJR.14.13454 25905963

13. Halleck F, Diederichs G, Koehlitz T, Slowinski T, Engelken F, Liefeldt L, et al. Volume matters: CT-based renal cortex volume measurement in the evaluation of living kidney donors. Transpl Int. 2013;26(12):1208–16. doi: 10.1111/tri.12195 24118327

14. Lee JH, Won JH, Oh C-K. Impact of the ratio of graft kidney volume to recipient body surface area on graft function after live donor kidney transplantation. Clinical Transplantation. 2011;25(6):E647–E55. doi: 10.1111/j.1399-0012.2011.01502.x 21906170

15. Hugen CM, Polcari AJ, Farooq AV, Fitzgerald MP, Holt DR, Milner JE. Size does matter: donor renal volume predicts recipient function following live donor renal transplantation. J Urol. 2011;185(2):605–9. doi: 10.1016/j.juro.2010.09.098 21168871

16. Saxena AB, Busque S, Arjane P, Myers BD, Tan JC. Preoperative renal volumes as a predictor of graft function in living donor transplantation. Am J Kidney Dis. 2004;44(5):877–85. 15492954

17. Han SS, Yang SH, Oh YJ, Cho JY, Moon KC, Ha J, et al. Graft volume as the surrogate marker for nephron number affects the outcomes of living-donor kidney transplantation. Clin Transplant. 2011;25(3):E327–35. doi: 10.1111/j.1399-0012.2011.01426.x 21395690

18. Nicholson ML, Windmill DC, Horsburgh T, Harris KP. Influence of allograft size to recipient body-weight ratio on the long-term outcome of renal transplantation. Br J Surg. 2000;87(3):314–9. doi: 10.1046/j.1365-2168.2000.01390.x 10718800

19. Miles AM, Sumrani N, John S, Markell MS, Distant DA, Maursky V, et al. The effect of kidney size on cadaveric renal allograft outcome. Transplantation. 1996;61(6):894–7. doi: 10.1097/00007890-199603270-00009 8623156

20. Gaston RS, Hudson SL, Julian BA, Laskow DA, Deierhoi MH, Sanders CE, et al. Impact of donor/recipient size matching on outcomes in renal transplantation. Transplantation. 1996;61(3):383–8. doi: 10.1097/00007890-199602150-00010 8610346

21. Lamb KE, Lodhi S, Meier-Kriesche HU. Long-term renal allograft survival in the United States: a critical reappraisal. Am J Transplant. 2011;11(3):450–62. doi: 10.1111/j.1600-6143.2010.03283.x 20973913

22. Zakhari N, Blew B, Shabana W. Simplified method to measure renal volume: the best correction factor for the ellipsoid formula volume calculation in pretransplant computed tomographic live donor. Urology. 2014;83(6):1444.e15–9.

23. Jones TB, Riddick LR, Harpen MD, Dubuisson RL, Samuels D. Ultrasonographic determination of renal mass and renal volume. J Ultrasound Med. 1983;2(4):151–4. doi: 10.7863/jum.1983.2.4.151 6854718

24. Kang KY, Lee YJ, Park SC, Yang CW, Kim YS, Moon IS, et al. A comparative study of methods of estimating kidney length in kidney transplantation donors. Nephrol Dial Transplant. 2007;22(8):2322–7. doi: 10.1093/ndt/gfm192 17452412

25. Ekberg H, Tedesco-Silva H, Demirbas A, Vitko S, Nashan B, Gurkan A, et al. Reduced exposure to calcineurin inhibitors in renal transplantation. N Engl J Med. 2007;357(25):2562–75. doi: 10.1056/NEJMoa067411 18094377

26. Nga HS, Garcia PD, Contti MM, Takase HM, de Carvalho MF, de Andrade LG. Different induction therapies for kidney transplantation with living donor. J Bras Nefrol. 2015;37(2):206–11. doi: 10.5935/0101-2800.20150033 26154641

27. Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006;145(4):247–54. doi: 10.7326/0003-4819-145-4-200608150-00004 16908915

28. McGee J, Magnus JH, Islam TM, Jaffe BM, Zhang R, Florman SS, et al. Donor-recipient gender and size mismatch affects graft success after kidney transplantation. J Am Coll Surg. 2010;210(5):718–25.e1, 25–6. doi: 10.1016/j.jamcollsurg.2009.12.032 20421037

29. Bunke M, Marx MA, Abul-Ezz S, Almquist G, Barone G, Ketel B. The poor accuracy of indirect measurements of cadaveric donor kidney weights. Clin Transplant. 1999;13(3):253–9. 10383106

30. Gaspari F, Ferrari S, Stucchi N, Centemeri E, Carrara F, Pellegrino M, et al. Performance of different prediction equations for estimating renal function in kidney transplantation. Am J Transplant. 2004;4(11):1826–35. doi: 10.1111/j.1600-6143.2004.00579.x 15476483


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PLOS One


2019 Číslo 11