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

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.
• 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.