Department of Surgery, Kwandong University College of Medicine, Myongji Hospital, Goyang, Korea.
Clin Transplant. 2011 Nov-Dec;25(6):E647-55. doi: 10.1111/j.1399-0012.2011.01502.x. Epub 2011 Sep 9.
Functioning nephron mass is a determinant of the graft function of kidney transplant recipients. The graft kidney volume and its weight have been reported to be surrogates of the nephron mass. To investigate the impact of the ratios of the surrogates to recipient body surface area (BSA) and body weight on the graft function within six months post-transplantation, we measured the graft kidney volume, using computed tomography with 3-dimensional reconstruction before transplantation, and measured the graft kidney weight during surgery. Ninety-four cases of live donor kidney transplants were included in this study. The graft kidney volume/recipient BSA ratio was correlated with the glomerular filtration rate (GFR) of recipients at one and six months post-transplantation (r = 0.416, p < 0.001 and r = 0.381, p < 0.001, respectively). We found a difference in the graft function between recipients with a graft kidney volume/recipient BSA ratio of ≥90.9 mL/m(2) and those with a ratio of <90.9 mL/m(2) (p < 0.001). Multivariate analysis demonstrated that the graft kidney volume/recipient BSA ratio and donor age are independent predictors of recipient GFR at one and six months post-transplantation (p < 0.05). During living donor and recipient matching, both the potential volume of the donated kidney and the body size of recipient should be considered.
肾单位数量是决定肾移植受者移植物功能的一个决定因素。移植物肾体积及其重量已被报道为肾单位数量的替代物。为了研究移植后 6 个月内替代物与受者体表面积（BSA）和体重的比值对移植物功能的影响，我们在移植前使用三维重建计算机断层扫描测量了移植物肾体积，并在手术期间测量了移植物肾重量。本研究纳入了 94 例活体供肾移植病例。移植肾体积/受者 BSA 比值与受者移植后 1 个月和 6 个月的肾小球滤过率（GFR）相关（r = 0.416，p < 0.001 和 r = 0.381，p < 0.001）。我们发现，移植肾体积/受者 BSA 比值≥90.9 mL/m2 的受者与比值<90.9 mL/m2 的受者之间的移植物功能存在差异（p < 0.001）。多变量分析表明，移植肾体积/受者 BSA 比值和供者年龄是移植后 1 个月和 6 个月受者 GFR 的独立预测因素（p < 0.05）。在活体供者和受者匹配中，应同时考虑捐献肾脏的潜在体积和受者的体型。
