Fate of kidneys from the same donor grafted into different recipients: do they behave similarly and are they influenced by donor-related factors?
BACKGROUND
The fate of paired kidneys might be similar and could therefore reflect the influence of donor-related factors on graft outcome.


METHODS
To verify whether two kidneys retrieved from a single donor and grafted into different recipients have similar short, and middle-term outcomes we investigated the clinical outcome of 103 pairs of cadaveric kidneys grafted into 206 recipients. We evaluated the influence of donor-related factors such as age, sex and cause of death, and of the storage solution and method of harvesting. The incidence of delayed graft function was considered as the short-term outcome and serum creatinine levels at two years as the middle-term outcome. We evaluated the difference from expected frequencies in the incidence of delayed graft function and the incidence of similar serum creatinine levels in each pair of recipients. Univariate analysis of possible risk factors was made by the t-test, chi2 test and Fisher test, as appropriate. Multivariate analysis was done by logistic regression analysis with a forward stepwise variable selection.


RESULTS
Delayed graft function was seen in both recipients from the same donor 2.5 times more than the expected frequency (p<0.001). Serum creatinine levels were similar in both recipients with a higher frequency than expected (p<0.01). Multivariate analysis showed that donor-related factors on graft function were age, cause of death and storage solution.


CONCLUSIONS
Paired kidneys have similar performances in both the short and the long term. Major donor-related factors in delayed graft function are age and the storage solution. Major donor-related factors in graft function are age and cause of death.
Bertoni
E
E
Renal Unit, Careggi University Hospital, Florence, Italy. nefrologia@ao-careggi.toscana.it
Zanazzi
M
M
Rosati
A
A
Rindi
P
P
Rizzo
G
G
Carmellini
M
M
Di Maria
L
L
Moscarelli
L
L
Salvadori
M
M
D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome