title: Estimated donor glomerular filtration rate is the most important donor characteristic predicting graft function in recipients of kidneys from live donors.
abstract: We hypothesized that predictors of outcome in live donor transplants were likely to differ significantly from deceased donor transplants, in which cold ischaemia time, cause of donor death and other donor factors are the most important predictors. The primary aim was to explore the independent predictors of graft function in recipients of live donor kidneys (LDK). Our secondary aim was to determine which donor characteristics are the most useful predictors. A retrospective analysis was undertaken of all patients receiving live donor (n = 206) renal transplants at our institution between 31 May 1994 and 15 October 2002. Twelve patients were excluded from the analysis. Follow-up was completed on all patients until graft loss, death or 22 November 2003. We explored predictors of Nankivell glomerular filtration rate (GFR) at 6 months by multivariate linear regression. In the 194 patients studied, the mean recipient 6-month Nankivell GFR was 59 +/- 15 ml/min/1.73 m(2). Independent predictors of recipient GFR in at 6 months were donor Cockcroft-Gault GFR (CrCl; beta 0.16; CI 0.13 to 0.29; P < 0.0001), steroid resistant rejection (beta-6.07; CI -12.05 to -0.09; P = 0.006) and delayed graft function (DGF) (beta-10.0; CI -19.52 to -0.49; P = 0.039). Renal function in an LDK transplant recipients is predicted by donor GFR, episodes of steroid resistant rejection and DGF. Importantly, donor Cockcroft-Gault GFR is the most important characteristic for predicting the recipient renal function.
authors.affiliation: Department of Nephrology, Southern Clinical School, University of Queensland, Princess Alexandra Hospital, Brisbane, Qld, Australia.
authors.forename: Carmel M
authors.initials: CM
authors.lastname: Hawley
authors.forename: Jamie
authors.initials: J
authors.lastname: Kearsley
authors.forename: Scott B
authors.initials: SB
authors.lastname: Campbell
authors.forename: David W
authors.initials: DW
authors.lastname: Mudge
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Isbel
authors.forename: David W
authors.initials: DW
authors.lastname: Johnson
authors.forename: Kylie
authors.initials: K
authors.lastname: May
authors.forename: John
authors.initials: J
authors.lastname: Preston
authors.forename: Anthony
authors.initials: A
authors.lastname: Griffin
authors.forename: Daryl
authors.initials: D
authors.lastname: Wall
authors.forename: John
authors.initials: J
authors.lastname: Burke
authors.forename: Steven J
authors.initials: SJ
authors.lastname: McTaggart
authors.forename: Gayle
authors.initials: G
authors.lastname: Frohloff
authors.forename: David
authors.initials: D
authors.lastname: Nicol
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005190:Family; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome