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Residual kidney function after donor nephrectomy. Assessment by 99mTc-MAG3-clearance.

N Hamscho1, A Wilhelm, N Döbert

  • 1Department of Nuclear Medicine, Hospital of the J.W.G.-University, Frankfurt am Main, Germany. hamscho@em.uni-frankfurt.de

Nuklearmedizin. Nuclear Medicine
|January 6, 2006
PubMed
Summary

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Long-term kidney donation results in 69% of normal kidney function, with the remaining kidney compensating well. Most donors maintain normal creatinine, and hypertension rates are similar to the general population.

Area of Science:

  • Nephrology
  • Nuclear Medicine
  • Transplantation Immunology

Background:

  • Donor nephrectomy is a significant surgical procedure.
  • Assessing long-term renal function in kidney donors is crucial for understanding donor outcomes.
  • 99mTc-mercaptoacetyltriglycin (MAG3)-clearance is a valuable tool for evaluating renal function.

Purpose of the Study:

  • To evaluate the long-term residual renal function in kidney donors after nephrectomy.
  • To establish reference values for renal function in kidney donors using 99mTc-MAG3-clearance.
  • To assess the compensatory capacity of the remaining kidney.

Main Methods:

  • A cohort of 49 kidney donors underwent 99mTc-MAG3-clearance testing.
  • Donors were evaluated 16+/-8 years post-nephrectomy.

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  • A subgroup of 20 donors had pre- and post-operative assessments for intra-individual comparison.

    • Main Results:

    • Kidney donors exhibited a mean 99mTc-MAG3-clearance of 69+/-15% of the normal mean value for individuals with two kidneys.
    • Total renal function decreased significantly from 84% preoperatively to 60% postoperatively in a subgroup (p <0.0005).
    • 22% of donors developed arterial hypertension post-donation, comparable to the general population.

    Conclusions:

    • Post-nephrectomy kidney donors with normal or slightly elevated creatinine have a mean 99mTc-MAG3-clearance of 69% of the two-kidney mean.
    • This value can serve as a reference for healthy individuals with one kidney.
    • Renal scintigraphy with 99mTc-MAG3-clearance demonstrates good contralateral kidney compensation.