Renal function after donor nephrectomy at a tertiary medical center in Southern Thailand
Keywords:
Kidney transplantation, donor nephrectomy, renal functionAbstract
Objective: The aim of this study was to assess long-term renal function after living donor nephrectomy and determine the optimal follow-up period.
Material and Method: A retrospective review of living donor kidney transplantation (LDKT) patients who underwent open donor nephrectomy. Clinical chart review was performed. Kidney function was measured before and after surgery. We assessed donor kidney function using the estimated Glomerular filtration rate (eGFR) through the Cockcroft and Gault formula. The evaluation of kidney function after surgery
was performed at 1 week, 1 month, 3 months, 6 months, and 12 months. Rate of renal function decline was analyzed and compared with the baseline.
Result: A total of 50 kidney donor patients were identified; the mean age of kidney donors was 39.18 (11.37) years old. The mean of eGFR before surgery was 92.4 (26.0) ml/min/1.73 m2. After surgery eGFR at 1 week, 1 month, 3 months, 6 months and 12 months was 66.8 (18.3) ml/min/1.73 m2, 66.8 (21.0) ml/min/
1.73 m2, 65.8 (18.6) ml/min/1.73 m2, 69.4 (17.4) ml/min/1.73 m2, 70.0(16.0) ml/min/1.73 m2 respectively. Kidney function was reduced and returned to a new baseline at 6 months after surgery. The overall new baseline eGFR decreased 22.6% from eGFR at pre-donation.
Conclusion: Renal function declined after open donor nephrectomy. Change in renal function is not associated with gender. New baseline of eGFR will occur at 6 months after surgery.
References
Attawettayanon W, Prasit S, Sangkum P, et at. Single Port Laparoscopic Donor Nephrectomy: First Case Report in Ramathibodi Hospital. J Med Assoc Thai 2014;97:250-253.
Shapiro R. End-stage renal disease in 2010: innovative approaches to improve outcomes in transplantation. Nat Rev Nephrol 2011;7:68-70.
Mjøen G, Øyen O, Midtvedt K, Dahle DO, Norby G, et al. Age, gender, and body mass index are associated with renal function after kidney donation.Clin Transplant 2011;25:E579-E583.
TimsitMO,Nguyen KN, Rouach Y, Elie C, et al. Kidney function following nephrectomy: Similitude and discrepancies between kidney cancer and living donation. Urol Oncol 2012;30:482-486.
Okamoto M, Akioka K, Nobori S, et al. Short-and long-term donor outcomes after kidney donation: analysis of 601 cases over a 35-year period at Japanese single center. Transplantation 2009;87:419-423.
Poggio ED, Braun WE, Davis C. The science of Stew-ardship: due diligence for kidney donors and kidney function in living kidney donation-evaluation, determinants, and implications for outcomes. Clin J Am Soc Nephrol 2009;4:1677-1684.
Garg AX, Muirhead N, Knoll G et al. Proteinuria and reduced kidney function in living kidney donors: a systematic review, meta-analysis, and meta-regression. Kidney Int 2006;70:1801-1810.
Kasiske BL, Ma JZ, Louis TA, Swan SK. Longterm effects of reduced renal mass in humans. Kidney Int 1995;48:814-819.
Ibrahim HN, Foley R, Tan L et al. Long-term conse-quences of kidney donation. N Engl J Med 2009;360:459-469.
Giessing M. living donor nephrectomy-Quantifying the risk for the donor. Transplant Proc 2012:44;1786-1789.
Fehrman-Ekholm I, Kvarnström N, Söfteland JM, et al. Post-nephrectomy development of renal function in living kidney donors: a crosssectional retrospective study. Nephrol Dial Transplant 2011;26:2076-2078.
Choi KH, Yang SC, Joo DJ, et al. Clinical Assessment of Renal Function Stabilization After Living Donor Nephrectomy. Transplant Proc 2012;44:2906-2909.
