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Association Between a Change in Donor Kidney Function and Long‐Term Allograft Outcomes in Kidney Transplant Recipients
Author(s) -
Oh IlHwan,
Lee ChangHwa,
Kim GheunHo,
Kang ChongMyung,
Park JoonSung
Publication year - 2015
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12367
Subject(s) - hazard ratio , renal function , medicine , kidney transplantation , dialysis , proportional hazards model , confidence interval , urology , kidney , transplantation , kidney transplant , surgery
Reserve capacity of donated kidney may be an important determinant of allograft survival in kidney transplantation ( KT ). Here, we investigate change in estimated glomerular filtration rate of donor kidney (Δ eGFR Donor ) over 30 days after KT as a predictor of the allograft function. A total of 222 recipients were divided into two groups according to Δ eGFR Donor as follows: Group I ( n = 110), Δ eGFR Donor ≥ −25%; Group II ( n = 112), Δ eGFR Donor < −25%. Three years after KT , Group I had a higher eGFR Recipient than Group II (55 ± 21 vs. 47 ± 22 mL/min/1.73 m 2 , P < 0.05). However, no differences in eGFR Recipient were detected between the two groups after 10 years. Linear regression analysis showed that Δ eGFR Donor was significantly associated with the eGFR Recipient at 3 years post‐transplantation, but not at 10 years post‐transplantation. In K aplan– M eier analysis, Group I had a greater dialysis‐free survival rate than Group II at the 10‐year follow‐up (84% vs. 76%, P < 0.05). However, no difference in overall survival rate between groups was detected. In the multivariate‐adjusted C ox proportional‐hazard model, Δ eGFR Donor was independently associated with future allograft loss (hazard ratio 0.973; 95% confidence interval 0.949–0.999). These results suggest that larger recovery of donor kidney function after KT donation is associated with better short/intermediate‐term allograft outcomes. Follow‐up assessment of donor kidney function may be useful to monitor KT recipients at risk for allograft loss.