Living-Donor Kidney Transplantation: Donor-Recipient Function Correlation.

BACKGROUND: With the rising prevalence of living-donor kidney transplantation, evaluation of factors correlated with renal function in the donor-recipient pair constitutes a main goal for kidney transplantation clinicians. Our objective was to analyze the more relevant donor characteristics that contribute to donor and recipient estimated glomerular filtration rates (eGFR) after 1 year.

METHODS: We evaluated 48 consecutive donor-recipient pairs from our unit.

RESULTS: Mean donor age was 46 ± 11 years, with 71% being women. Mean recipient age was 35 ± 12 years, with 54% being men. Mean duration of donor hospitalization was 7 ± 2 days. Donor eGFR was 104 ± 11 mL/min/1.73 m2 before donation and 70 ± 14 mL/min/1.73 m2 at discharge. After 1 year, donor eGFR was 71 ± 12 mL/min/1.73 m2 and recipient eGFR was 69 ± 10 mL/min/1.73 m2 . Donor eGFR <100 mL/min/1.73 m2 before donation and age >50 years correlated with 17.7- and 8.9-fold increased risks, respectively, of recipient eGFR <60 mL/min/1.73 m2 after 1 year. Donor being female, although statistically associated with worse graft function, compared with a male donor (P = .020), did not represent a significantly increased risk of recipient eGFR <60 mL/min/1.73 m2 . Higher donor body mass index (BMI) also associated with a lower kidney function for donors (P = .048). In multivariate linear regression to predict pairs' eGFRs after 1 year, only donor eGFR before donation and at discharge retained statistical significance (P ≤ .001 and P = .045, respectively).

CONCLUSIONS: Excluding unpredictable complications in the post-transplantation period, donor eGFR before donation, eGFR at discharge, and age were the best parameters to predict recipient and donor eGFRs after 1 year and can be used as a tool for managing expectations regarding the post-transplantation period.