The Role Of Donor/recipient Body Surface Area Ratio And Single Kidney Glomerular Filtration Rate In Kidney Choice In Living-related Donor Kidney Transplantation

Abstract:The role of donor/recipient(D/R) body surface area(BSA) ratio and single kidney glomerular filtration rate(SKGFR) in kidney choice in living-related donor kidney transplantation(LDKT).Methods:Between October 2007 and October 2011, 204 cases of LDKT with a functional graft who were regularly followed up for more than two years in the First Affiliated Hospital of Zhengzhou University comprised the population that was analyzed in this study. According to SKGFR and D/R BSA ratio, the recipients were allocated into 6 groups: group A(SKGFR<40ml/min, D/R BSA ratio ≤ 0.8), group B(SKGFR<40ml/min, 0.8<D/R BSA ratio<1.2), group C(SKGFR<40ml/min, D/R BSA ratio ≥ 1.2), group D(SKGFR ≥ 40ml/min, D/R BSA ratio ≤ 0.8), group E(SKGFR≥40ml/min, 0.8<D/R BSA ratio<1.2), group F(SKGFR≥40ml/min, D/R BSA ratio≥1.2). The database included donor, recipient and transplant variables. We recorded renal function of the recipients at 1 week, 2 week, 1 month, 3 months, 6 months, 12 months and 24 months post-operation respectively.Results:The declining rate of serum creatinine(SCr), SCr and graft e GFR in stable periods after transplantation in SKGFR≥40ml/min group were slightly better than SKGFR<40ml/min group, yet there did not exist statistical differences between these two groups(P≥0.05). The recovery of graft function for recipients with D/R BSA ratio≤0.8 was worse than those with D/R BSA ratio≥ 1.2 and the difference between the two groups was always statistically significant(P<0.05). The rate of decline in SCr, SCr and graft e GFR in stable periods after transplantation in group A were always worse than the other five groups, and the difference was statistically significant(P<0.05). The rate of decline in SCr, SCr and graft e GFR in stable periods after transplantation in group C and group F were always better than the other four groups, and the difference was statistically significant(P <0.05).Conclusions:We should consider both SKGFR and D/R BSA ratio when we choose potential living-related donors. We should avoid choosing donor kidneys from SKGFR <40ml/min, in addition to D/R BSA ratio ≤ 0.8. It may achieve satisfactory graft function when we choose SKGFR <40ml and D/R BSA ratio ≥ 0.8.