Influence Of Preoperative Factors On Early Graft Function In Living Donor Kidney Transplantation

Objectives.The aim was to investigate the preoperative factors of donors and recipients that affect early graft function after transplantation in living donor kidney transplantation.Methods.This retrospective study included269patients who underwent first living donor renal transplantation at at the Kidney Disease Center, First Affiliated Hospital, Medical College of Zhejiang University from April2007to April2011. We performed the liner regression analysis of independent impact of preoperative factors on graft estimated glomerular filtration rate (eGFR) at6months post-transplant. To facilitate the analysis and interpretation of the results, the data were subdivided into subgroups. Patients were stratified into two groups according to mean±SD of donor age:<45yr and≥45yr. The D/R BSA ratio were divided into three groups as follows:≤0.9(Group A),0.91-1.09(Group B) and≥1.1(Group C).Results.The donor age was correlated inversely with graft function at6months (coefficient=-0.53, P<0.001). The donor variables (male, D-BSA, donor eGFR) associated with size or function of the donor-kidney were positively correlated to the graft eGFR at6months. Whileas the recipient variables (male, R-BSA, R-BMI) associated with metabolic demand of recipients were inversely correlated. The better donor-recipient BSA matching (D/R BSA ratio, coefficient=35.74, P<0.001) was strongly associated with higher eGFR. In the multivariate model, donor age, donor eGFR and D/R BSA ratio were the independent predictors of graft function. By stratified analysis, the valuable effect of D/R BSA ratio was still reserved in recipients of grafts from donors with age older than45years old.Conclusion.Among the preoperative factors, donor age, donor eGFR and D/R BSA ratio are independent predictors on early graft function in living donor renal transplantation. During preoperative evaluation, the donor and recipient BSA matching should be considered among otherwise similar potential older age donors to improve early graft function after transplantation.