Compensation Capacity of The Living-Related Donor’s Remnant Kidney and Recipient’s Transplanted Kidney

Background: Compensatory renal growth following nephrectomy is common. We try to explore the compensatory capacity of the living-related donor’s remnant kidney and recipient’s transplanted kidney in terms of the glomerular filtration rate (GFR) one month after transplantation. Methods: Clinical data of 94 patients who received living-related kidney transplantation in our hospital between June 2007 and December 2017 were reviewed retrospectively. GFR was calculated by 99mTc-DTPA detection. The GFR compensatory capacity of donor’s remnant and donated kidneys in their new milieus after transplantation was compared. The differential value (D-value) of split renal function was defined as postoperative GFR - preoperative ipsilateral GFR. The compensatory percentage (C-percentage) of split renal function was defined as (postoperative GFR - preoperative ipsilateral GFR)/preoperative ipsilateral GFR. Results: The median D-value of the donor’s remnant kidney increased by 20.8 ml/(min·1.73m2)[IQR=8.9-29.6 ml/(min·1.73m2)] with a C-percentage of 46.6% (IQR=17.0%-73.0%). The median D-value of the donated kidney increased by 30.6 ml/(min·1.73m2)[IQR=19.8-42.3 ml/(min·1.73m2)] with a C-percentage of 67.8% (IQR=39.6%-94.7%). Multivariable analysis showed that only split preoperative GFR in the donor was the independent predictor for C-percentage of the split kidney. Conclusions: Renal function could be well preserved and compensated after kidney donation in most donors and recipients in Chinese population. Healthy donors with a good GFR before operation possessed a mighty functional compensation capacity.