Determination of predonation single kidney GFR in living kidney donor transplantation to predict renal allograft function and donor functional gain

Abstract : Currently, two main objectives are discussed about living kidney transplantation. On the first hand, providing the best graft function and on the other hand, ensuring the safety of donation. In our study, we hypothesized that the single kidney GFR (sk GFR) of the transplanted kidney might predict the graft function and the sk GFR of the remaining kidney also predict the donor functional gain. We conducted a prospective monocentric study in Grenoble-Alpes University Hospital including 20 couples of donors and recipients who had a DMSA renal scintigraphy and 51Cr-EDTA clearance in predonation evaluation in order to calculate their sk GFR. All patients underwent renal function assessment by 51Cr-EDTA clearance one-year after transplantation to measure graft function and donor functional gain. All donors had predonation normal renal function. At one-year post transplantation, the median m GFR of graft was 50ml/min/1.73m2 (range 46-56) and the donor m GFR was 59ml/min/1.73m2 (range 55-74). The median functional gain was 20ml/min/1.73m2 (range 12-22). No statistically correlation could have been established between sk GFR of the transplanted kidney with the graft function at one-year (R2=0.096, p=0.7). For the donor, functional gain was not associated with predonation single kidney GFR of the remaining kidney (R2=0.17, p=0.5). A statistically difference was shown between donor functional gain (18±10) and recipient gain (delta between sk GFR before and after transplantation) (7±16) (p=0.02). Furthers studies with more statistical power have to been done in order to highlight the influencing factors of the renal function post transplantation.
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Master Thesis
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Morgane Heitz. Determination of predonation single kidney GFR in living kidney donor transplantation to predict renal allograft function and donor functional gain. Human health and pathology. 2018. ⟨dumas-01959076⟩

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