N AUNG1, G CHIN1
1Department of Nephrology and Renal Transplantation, Fiona Stanley Hospital, Murdoch, Western Australia
Aim: This study was to identify the difference in pre and post-donor nephrectomy’s creatinine/ eGFR and using LKDPI score to compare the quality of donor kidney and the outcome.
Methods: A retrospective study of 21 living kidney donors, over the period of 2014-2016 in a single centre, of their pre and post donor nephrectomy’s renal functions and application of LKDPI in those population to identify scores and best renal graft function based on creatinine (umol/l).
Results: The study included 21-living-donors, mean age 52 years, 52% female, baseline-eGFR>90ml/min, mean SBP 124mmHg , mean BMI 25.87, 14% cigarette usage, 62% biologically related, 33% ABO-incompatible, mean donor/recipient weight ratio 1.05 , 33% HLA-B-two-mismatch and 24% HLA-DR-two-mismatch.
The results showed that there was 33% decline in eGFR post-donor nephrectomy day 1, 30% decline in eGFR post-op 1 month and 31% decline in eGFR post-op 1 year. Mean LKDPI was 25 (range -23 to 50) with best renal graft function (creatinine) being 104 umol/l (range 69-178) and the Pearson’s correlation between LKDPI and best renal graft function (creatinine) was 0.0391 (p value 0.8665, NS).
Conclusions: These information helps to explain to potential living donors about expected percentage loss of their renal function’s eGFR (in range of 31% to 33%) in the post-donor nephrectomy, which was consistent with previous studies. We can apply LKDPI to help comparing living donor kidneys to each other and to deceased donor kidneys, which we can use to evaluate the quality of the donation.
Limitation: Single centre, retrospective cohort study, small sample size, LKDPI calculation was based on US transplant populations rather than those of Australia; limited predictive value (i.e. discrimination) of the model (concordance index=0.59)