title: Postoperative Compensatory Changes and Blood Flow Parameter of the Preserved Kidney in Elderly Living Related Donors Evaluated by Doppler Ultrasonography.
abstract: BACKGROUND
  Elderly kidney donors have recently become more common in living related kidney transplantation in Japan. Therefore, it is important to evaluate whether kidney function in elderly donors after nephrectomy is preserved over long periods of time. Doppler ultrasonography measurement is practical for donors after nephrectomy because it involves simple and noninvasive examinations. Doppler ultrasonography can detect compensatory hypertrophy and blood flow parameters, namely resistive index (RI) and pulsatility index (PI), of the preserved kidney in living donors.
  
  
  METHODS
  Our study included 58 donors, divided into 2 groups according to age; the elderly donor group was comprised of those 65 years old or older. We measured length, width, and short diameter of the preserved kidney using Doppler ultrasonography, and calculated kidney volume.
  
  
  RESULTS
  The elderly group was comprised of 13 patients. In this group, the median preserved kidney volume was 145.0 cm(3) (101.8-193.5) before nephrectomy, and 127.6 cm(3) (99.0-183.4) and 145.5 cm(3) (141.3-148.6) at 1 and 12 months after nephrectomy, respectively. We did not observe significant compensatory hypertrophy in the preserved kidneys of elderly donors postoperatively. Both the mean PI and RI values of elderly donors increased progressively after nephrectomy. No compensatory hypertrophy occurred in the preserved kidneys of elderly donors, although the PI and RI did increase in these donors.
  
  
  CONCLUSIONS
  Our results indicate that nephrectomy caused nephrosclerosis in the preserved kidneys of elderly donors and that prevention of hypertension may be important after nephrectomy in elderly donors.
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan. Electronic address: konno@tokyo-med.ac.jp.
authors.forename: O
authors.initials: O
authors.lastname: Konno
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kihara
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Iwamoto
authors.affiliation: Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kawachi
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000209:etiology*; D007564:Japan; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging / Q000378:metabolism; D016030:Kidney Transplantation / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D009400:Nephrosclerosis / Q000000981:diagnostic imaging / Q000209:etiology*; D011183:Postoperative Complications; D011184:Postoperative Period; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods; D018608:Ultrasonography, Doppler