Live donor renal anatomic asymmetry and posttransplant renal function

Bekir Tanriover, Sonalis Fernandez, Eric S. Campenot, Jeffrey H. Newhouse, Irina Oyfe, Prince Mohan, Burhaneddin Sandikci, Jai Radhakrishnan, Jennifer J. Wexler, Maureen A. Carroll, Sairah Sharif, David J. Cohen, Lloyd E. Ratner, Mark A. Hardy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background. Relationship between live donor renal anatomic asymmetry and posttransplant recipient function has not been studied extensively. Methods. We analyzed 96 live kidney donors, who had anatomical asymmetry (>10% renal length and/or volume difference calculated from computerized tomography angiograms) and their matching recipients. Split function differences (SFD) were quantified with technetium-dimercaptosuccinic acid renography. Implantation biopsies at time 0 were semiquantitatively scored. A comprehensive model using donor renal volume adjusted to recipient weight (Vol/Wgt), SFD, and biopsy score was used to predict recipient estimated glomerular filtration rate (eGFR) at 1 year. Primary analysis consisted of a logistic regression model of outcome (odds of developing eGFR>60 mL/min/1.73m<sup>2</sup> at 1 year), a linear regression model of outcome (predicting recipient eGFR at one-year, using the chronic kidney disease-epidemiology collaboration formula), and a Monte Carlo simulation based on the linear regression model (N=10, 000 iterations). Results. In the study cohort, the mean Vol/Wgt and eGFR at 1 year were 2.04 mL/kg and 60.4 mL/min/1.73 m<sup>2</sup>, respectively. Volume and split ratios between 2 donor kidneys were strongly correlated (r = 0.79, P < 0.001). The biopsy scores among SFD categories (<5%, 5%-10%, >10%) were not different (P = 0.190). On multivariate models, only Vol/Wgt was significantly associated with higher odds of having eGFR > 60 mL/min/1.73 m<sup>2</sup> (odds ratio, 8.94, 95% CI 2.47-32.25, P = 0.001) and had a strong discriminatory power in predicting the risk of eGFR less than 60 mL/min/1.73 m<sup>2</sup> at 1 year [receiver operating curve (ROC curve), 0.78, 95% CI, 0.68-0.89]. Conclusions. In the presence of donor renal anatomic asymmetry, Vol/Wgt appears to be a major determinant of recipient renal function at 1 year after transplantation. Renography can be replaced with CT volume calculation in estimating split renal function.

Original languageEnglish (US)
Pages (from-to)e66-e74
JournalTransplantation
Volume99
Issue number8
DOIs
StatePublished - Aug 1 2015

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Glomerular Filtration Rate
Kidney
Linear Models
Radioisotope Renography
Logistic Models
Succimer
Biopsy
Cone-Beam Computed Tomography
Technetium
Chronic Renal Insufficiency
ROC Curve
Angiography
Epidemiology
Cohort Studies
Transplantation
Odds Ratio
Tomography
Weights and Measures

ASJC Scopus subject areas

  • Transplantation

Cite this

Tanriover, B., Fernandez, S., Campenot, E. S., Newhouse, J. H., Oyfe, I., Mohan, P., ... Hardy, M. A. (2015). Live donor renal anatomic asymmetry and posttransplant renal function. Transplantation, 99(8), e66-e74. https://doi.org/10.1097/TP.0000000000000599

Live donor renal anatomic asymmetry and posttransplant renal function. / Tanriover, Bekir; Fernandez, Sonalis; Campenot, Eric S.; Newhouse, Jeffrey H.; Oyfe, Irina; Mohan, Prince; Sandikci, Burhaneddin; Radhakrishnan, Jai; Wexler, Jennifer J.; Carroll, Maureen A.; Sharif, Sairah; Cohen, David J.; Ratner, Lloyd E.; Hardy, Mark A.

In: Transplantation, Vol. 99, No. 8, 01.08.2015, p. e66-e74.

Research output: Contribution to journalArticle

Tanriover, B, Fernandez, S, Campenot, ES, Newhouse, JH, Oyfe, I, Mohan, P, Sandikci, B, Radhakrishnan, J, Wexler, JJ, Carroll, MA, Sharif, S, Cohen, DJ, Ratner, LE & Hardy, MA 2015, 'Live donor renal anatomic asymmetry and posttransplant renal function', Transplantation, vol. 99, no. 8, pp. e66-e74. https://doi.org/10.1097/TP.0000000000000599
Tanriover B, Fernandez S, Campenot ES, Newhouse JH, Oyfe I, Mohan P et al. Live donor renal anatomic asymmetry and posttransplant renal function. Transplantation. 2015 Aug 1;99(8):e66-e74. https://doi.org/10.1097/TP.0000000000000599
Tanriover, Bekir ; Fernandez, Sonalis ; Campenot, Eric S. ; Newhouse, Jeffrey H. ; Oyfe, Irina ; Mohan, Prince ; Sandikci, Burhaneddin ; Radhakrishnan, Jai ; Wexler, Jennifer J. ; Carroll, Maureen A. ; Sharif, Sairah ; Cohen, David J. ; Ratner, Lloyd E. ; Hardy, Mark A. / Live donor renal anatomic asymmetry and posttransplant renal function. In: Transplantation. 2015 ; Vol. 99, No. 8. pp. e66-e74.
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abstract = "Background. Relationship between live donor renal anatomic asymmetry and posttransplant recipient function has not been studied extensively. Methods. We analyzed 96 live kidney donors, who had anatomical asymmetry (>10{\%} renal length and/or volume difference calculated from computerized tomography angiograms) and their matching recipients. Split function differences (SFD) were quantified with technetium-dimercaptosuccinic acid renography. Implantation biopsies at time 0 were semiquantitatively scored. A comprehensive model using donor renal volume adjusted to recipient weight (Vol/Wgt), SFD, and biopsy score was used to predict recipient estimated glomerular filtration rate (eGFR) at 1 year. Primary analysis consisted of a logistic regression model of outcome (odds of developing eGFR>60 mL/min/1.73m2 at 1 year), a linear regression model of outcome (predicting recipient eGFR at one-year, using the chronic kidney disease-epidemiology collaboration formula), and a Monte Carlo simulation based on the linear regression model (N=10, 000 iterations). Results. In the study cohort, the mean Vol/Wgt and eGFR at 1 year were 2.04 mL/kg and 60.4 mL/min/1.73 m2, respectively. Volume and split ratios between 2 donor kidneys were strongly correlated (r = 0.79, P < 0.001). The biopsy scores among SFD categories (<5{\%}, 5{\%}-10{\%}, >10{\%}) were not different (P = 0.190). On multivariate models, only Vol/Wgt was significantly associated with higher odds of having eGFR > 60 mL/min/1.73 m2 (odds ratio, 8.94, 95{\%} CI 2.47-32.25, P = 0.001) and had a strong discriminatory power in predicting the risk of eGFR less than 60 mL/min/1.73 m2 at 1 year [receiver operating curve (ROC curve), 0.78, 95{\%} CI, 0.68-0.89]. Conclusions. In the presence of donor renal anatomic asymmetry, Vol/Wgt appears to be a major determinant of recipient renal function at 1 year after transplantation. Renography can be replaced with CT volume calculation in estimating split renal function.",
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AU - Tanriover, Bekir

AU - Fernandez, Sonalis

AU - Campenot, Eric S.

AU - Newhouse, Jeffrey H.

AU - Oyfe, Irina

AU - Mohan, Prince

AU - Sandikci, Burhaneddin

AU - Radhakrishnan, Jai

AU - Wexler, Jennifer J.

AU - Carroll, Maureen A.

AU - Sharif, Sairah

AU - Cohen, David J.

AU - Ratner, Lloyd E.

AU - Hardy, Mark A.

PY - 2015/8/1

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N2 - Background. Relationship between live donor renal anatomic asymmetry and posttransplant recipient function has not been studied extensively. Methods. We analyzed 96 live kidney donors, who had anatomical asymmetry (>10% renal length and/or volume difference calculated from computerized tomography angiograms) and their matching recipients. Split function differences (SFD) were quantified with technetium-dimercaptosuccinic acid renography. Implantation biopsies at time 0 were semiquantitatively scored. A comprehensive model using donor renal volume adjusted to recipient weight (Vol/Wgt), SFD, and biopsy score was used to predict recipient estimated glomerular filtration rate (eGFR) at 1 year. Primary analysis consisted of a logistic regression model of outcome (odds of developing eGFR>60 mL/min/1.73m2 at 1 year), a linear regression model of outcome (predicting recipient eGFR at one-year, using the chronic kidney disease-epidemiology collaboration formula), and a Monte Carlo simulation based on the linear regression model (N=10, 000 iterations). Results. In the study cohort, the mean Vol/Wgt and eGFR at 1 year were 2.04 mL/kg and 60.4 mL/min/1.73 m2, respectively. Volume and split ratios between 2 donor kidneys were strongly correlated (r = 0.79, P < 0.001). The biopsy scores among SFD categories (<5%, 5%-10%, >10%) were not different (P = 0.190). On multivariate models, only Vol/Wgt was significantly associated with higher odds of having eGFR > 60 mL/min/1.73 m2 (odds ratio, 8.94, 95% CI 2.47-32.25, P = 0.001) and had a strong discriminatory power in predicting the risk of eGFR less than 60 mL/min/1.73 m2 at 1 year [receiver operating curve (ROC curve), 0.78, 95% CI, 0.68-0.89]. Conclusions. In the presence of donor renal anatomic asymmetry, Vol/Wgt appears to be a major determinant of recipient renal function at 1 year after transplantation. Renography can be replaced with CT volume calculation in estimating split renal function.

AB - Background. Relationship between live donor renal anatomic asymmetry and posttransplant recipient function has not been studied extensively. Methods. We analyzed 96 live kidney donors, who had anatomical asymmetry (>10% renal length and/or volume difference calculated from computerized tomography angiograms) and their matching recipients. Split function differences (SFD) were quantified with technetium-dimercaptosuccinic acid renography. Implantation biopsies at time 0 were semiquantitatively scored. A comprehensive model using donor renal volume adjusted to recipient weight (Vol/Wgt), SFD, and biopsy score was used to predict recipient estimated glomerular filtration rate (eGFR) at 1 year. Primary analysis consisted of a logistic regression model of outcome (odds of developing eGFR>60 mL/min/1.73m2 at 1 year), a linear regression model of outcome (predicting recipient eGFR at one-year, using the chronic kidney disease-epidemiology collaboration formula), and a Monte Carlo simulation based on the linear regression model (N=10, 000 iterations). Results. In the study cohort, the mean Vol/Wgt and eGFR at 1 year were 2.04 mL/kg and 60.4 mL/min/1.73 m2, respectively. Volume and split ratios between 2 donor kidneys were strongly correlated (r = 0.79, P < 0.001). The biopsy scores among SFD categories (<5%, 5%-10%, >10%) were not different (P = 0.190). On multivariate models, only Vol/Wgt was significantly associated with higher odds of having eGFR > 60 mL/min/1.73 m2 (odds ratio, 8.94, 95% CI 2.47-32.25, P = 0.001) and had a strong discriminatory power in predicting the risk of eGFR less than 60 mL/min/1.73 m2 at 1 year [receiver operating curve (ROC curve), 0.78, 95% CI, 0.68-0.89]. Conclusions. In the presence of donor renal anatomic asymmetry, Vol/Wgt appears to be a major determinant of recipient renal function at 1 year after transplantation. Renography can be replaced with CT volume calculation in estimating split renal function.

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