A Study to Determine If Donor Kidney Volume Influences Kidney Function After Renal Transplantation

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2026-07-01 Epub Date: 2026-06-12 DOI:10.1016/j.transproceed.2026.05.024

Abhijit Konnur, Sishir Gang, Umapati Hegde, Hardik Patel, Akashkumar Pandya, Harshil Shukla, Yogesh Rathi, Nitiraj Shete

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Abstract

Introduction

Kidney transplantation is the preferred treatment for end-stage renal disease. Donor kidney volume (DKV) and its adjustment to recipient body surface area (BSA), termed nephron dose (DKV/BSA), may influence graft function based on the nephron dosing hypothesis. This study evaluated the impact of nephron dose on recipient estimated glomerular filtration rate (eGFR) at 1 year.

Materials and Methods

A prospective observational study was conducted on 130 living donor kidney transplants at a tertiary care center (August 2022 to July 2023). Donor kidney volume was measured via computed tomography angiography and 3-dimensional volumetric analysis. Nephron dose (mL/m²) was calculated and correlated with recipient eGFR (Chronic Kidney Disease Epidemiology Collaboration 2021) at baseline, 3, 6, and 12 months. A ≥30% eGFR decline from peak was defined as significant deterioration.

Results

The mean DKV was 103.2 ± 20.9 mL, with a mean nephron dose of 64.5 ± 14.7 mL/m². A significant positive correlation was observed between nephron dose and eGFR, strongest at baseline (r = 0.436) and persisting at 1 year (r = 0.184). Receiver operating characteristic curve analysis identified a nephron dose cutoff of 61.88 mL/m², predicting >30% eGFR decline with 79.3% sensitivity and 54.1% specificity (area under the curve = 0.634, P = .028).

Conclusion

Donor kidney volume relative to recipient size significantly predicts graft function at 1 year. Incorporating nephron dose into preoperative planning may optimize donor-recipient matching and improve long-term outcomes.

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肾移植后供体肾容量是否影响肾功能的研究。

肾移植是治疗终末期肾病的首选方法。根据肾单位剂量假说，供体肾体积（DKV）及其对受体体表面积（BSA）的调节称为肾单位剂量（DKV/BSA），可能影响移植物功能。本研究评估了肾素剂量对受体1年肾小球滤过率（eGFR）的影响。材料与方法：对某三级医疗中心130例活体肾移植进行前瞻性观察研究（2022年8月至2023年7月）。通过计算机断层血管造影和三维体积分析测量供体肾脏体积。在基线、3、6和12个月时计算肾单位剂量（mL/m²）并与受体eGFR（慢性肾脏疾病流行病学协作2021）相关。eGFR从峰值下降≥30%定义为显著恶化。结果：平均DKV为103.2±20.9 mL，平均肾单位剂量为64.5±14.7 mL/m²。肾单位剂量与eGFR之间存在显著的正相关，在基线时最强（r = 0.436），并持续到1年（r = 0.184）。受试者工作特征曲线分析确定肾元剂量截止值为61.88 mL/m²，预测eGFR下降约30%，敏感性为79.3%，特异性为54.1%（曲线下面积= 0.634,P = 0.028）。结论：供体肾体积相对于受体肾体积可显著预测1年移植肾功能。将肾元剂量纳入术前计划可以优化供体-受体匹配并改善长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.