title: Effect of donor/recipient body weight mismatch on patient and graft outcome in living-donor kidney transplantation.
abstract: OBJECTIVE
  There have been conflicting reports showing that kidneys from small donors may be at risk for graft loss if they are transplanted into large recipients. The aim of this work was to examine the donor/recipient body weight ratio (D/RBWR) on patient and graft outcome.
  
  
  METHODS
  During the period from January 1990 to January 2002, 856 kidney transplants were performed. Of these, 776 kidney transplant recipients were selected after exclusion of pediatric, second transplant patients and those with a body mass index of 35. All patients achieved a minimum follow-up of 1-year. According to D/RBWR, patients were divided into 3 groups: low (0.9), medium (0.91-1.2) and high (1.2). Data were collected on graft function, acute and chronic rejection, post-transplant complications, and 1- and 5-year graft and patient survival.
  
  
  RESULTS
  There was a statistically significant increase in the incidence of chronic rejection, post-transplant hypertension and diabetes mellitus in the low group. The incidence and frequency of acute rejection episodes were nearly the same in the 3 groups. Graft function, estimated by serum creatinine at 1 year, was significantly lower in the low group. The 5-year graft and patient survival was 71, 80, 88 and 81, 85 and 92%, in the low, medium and high groups, respectively.
  
  
  CONCLUSIONS
  We conclude that a low D/RBWR may contribute to inferior long-term renal allograft survival. The hyperfiltration hypothesis due to low nephron mass in the low D/RBWR group may explain these findings.
authors.affiliation: Urology and Nephrology Center, Mansoura University, Egypt. amgadelbaz@ahram0505.net
authors.forename: Amgad E
authors.initials: AE
authors.lastname: el-Agroudy
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Hassan
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Bakr
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Foda
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Shokeir
authors.forename: Ahmed B
authors.initials: AB
authors.lastname: Shehab el-Dein
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001835:Body Weight; D016009:Chi-Square Distribution; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis