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Updated: Feb 6, 2026
08:12
Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
Published on: July 15, 2015
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Living donor postnephrectomy kidney function and recipient graft loss: A dose-response relationship
Courtenay M Holscher1, Tanveen Ishaque1, Jacqueline M Garonzik Wang1
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Summary
Lower kidney function in living kidney donors after surgery is linked to higher recipient graft failure. Donor BMI modifies this risk, with lower BMI donors showing a greater association with graft loss.
Area of Science:
- Nephrology
- Transplant Surgery
- Epidemiology
Background:
- Living kidney donation is crucial for transplant recipients.
- Donor end-stage renal disease (ESRD) is linked to recipient graft loss.
- Early post-donation donor kidney function may predict recipient outcomes.
Purpose of the Study:
- To investigate the association between donor 6-month postnephrectomy estimated glomerular filtration rate (eGFR) and recipient death-censored graft failure (DCGF).
- To explore if donor body mass index (BMI) modifies this relationship.
- To assess the potential for early recipient risk prediction based on donor response to nephrectomy.
Main Methods:
- Analysis of national registry data from 29,464 living kidney donor-recipient pairs (2008-2016).
- Statistical modeling to determine the association between donor post-donation eGFR and recipient DCGF.
- Exploration of donor BMI as an effect modifier on the eGFR-DCGF relationship.
Main Results:
- A decrease in donor post-donation eGFR was associated with an increased risk of recipient DCGF (aHR 1.06 per 10 mL/min decrement).
- This association was attenuated in donors with higher BMI (BMI=30, BMI=35).
- Recipients from donors with lower BMI (BMI=20, BMI=25) showed a significantly higher risk of DCGF with declining donor eGFR.
Conclusions:
- Donor post-donation eGFR is an early indicator of recipient graft loss risk.
- Donor BMI plays a significant role in modifying this association.
- Findings can inform pre-transplant counseling and post-transplant management strategies for living donor kidney transplant recipients.
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