Decrease in 1-year Kidney Graft Size Predicts Inferior Outcomes After Deceased Donor Kidney Transplantation.

Abstract:

BACKGROUND:Longest bipolar length of the kidney graft is routinely measured for ultrasonographic assessment of graft size (GS), although the value of the graft length remains unclear. METHODS:In a single-center, observational study involving 319 deceased-donor kidney transplant recipients, we assessed variations in absolute and adjusted GS (corrected for body surface area) between 1 and 12 months after transplantation ([INCREMENT]GS1m→12m). We tested whether variations in GS during the first year were predictive of the composite outcome of a reduction of 50% or more in the estimated glomerular filtration rate or end-stage graft failure. RESULTS:At 1 year after transplantation, 121 patients (38%) had a decrease in GS ([INCREMENT]GS1m→12m <0), and 198 patients (62%) had an increase in GS ([INCREMENT]GS1m→12m ≥0). After a median follow-up of 53 months, 41 patients with a decrease in GS reached the composite outcome as compared with 12 patients with an increase in GS (34% and 6%, respectively; P < 0.001). Areas under the receiver operating characteristics curves of absolute and adjusted [INCREMENT]GS1m→12m for composite outcome were 0.81 (95% confidence interval [95% CI], 0.74-0.88) and 0.78 (95% CI, 0.70-0.86), respectively. In multivariate analysis, the risk of the composite outcome was significantly higher among patients with a decrease in GS during the first year after transplantation (hazard ratio, 4.55; 95% CI, 2.35-8.81; P < 0.001). CONCLUSIONS:A decrease in kidney GS during the first year after transplantation, as compared with an increase in GS, is a powerful predictor of subsequent graft dysfunction or end-stage graft failure.

journal_name

Transplantation

journal_title

Transplantation

authors

Černe S,Arnol M,Kandus A,Buturović-Ponikvar J

doi

10.1097/TP.0000000000000977

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

1759-66

issue

8

eissn

0041-1337

issn

1534-6080

journal_volume

100

pub_type

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