UP-112 Predictors of Perioperative and One-Year Renal Functional Outcomes in Laparoscopic Kidney Donors
Thursday June 27, 2019 from

Ryan Sun, Canada

University of Manitoba


Predictors of perioperative and one-year renal functional outcomes in laparoscopic kidney donors

Ryan Sun1, Lourens Jacobs2, Angie Liu2, Thomas McGregor3, Rahul K. Bansal1.

1Section of Urology, University of Manitoba, Winnipeg, MB, Canada; 2Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada; 3Urology, Queen's University, Kingston, ON, Canada

Introduction: Ensuring the safety of living kidney donors is paramount, especially as donor criteria are expanded to meet the growing demand of kidney transplantation. In this study, we aim to assess potential predictors of perioperative outcomes in those undergoing laparoscopic donor nephrectomy (LDN).

Methods: This was a retrospective study involving all donors who underwent LDN from 2011 to 2020 at the Health Sciences Centre in Winnipeg, Canada. Various patient clinical and anatomical factors were compared with operative outcomes, kidney biopsy findings, and post-donation renal function, measured as estimated glomerular filtration rate (eGFR), during the one-year post-operative period.

Results: A total of 197 donors were identified. LDN was well-tolerated regardless of patient clinical and anatomical characteristics. Age >60 years correlated with the presence of chronic histopathological changes on biopsy, corresponded to lower pre- and post-donation renal function (p<0.01), and was predictive of eGFR<45 at one year (p<0.01).  Smoking and hypertension were associated with histopathological changes and statistically non-significant decline in eGFR. Controlling for age, interstitial fibrosis on biopsy remained predictive of eGFR <45 at one year.

Conclusions: Among carefully selected kidney donors, LDN appears to be safe with excellent perioperative risk profile regardless of age, gender, co-morbidities, side of nephrectomy, and number of renal vessels. Advancing age is predictive of significantly lower post-donation renal function within one year, likely secondary to baseline histopathological changes in the donor kidney. Donors with known risk factors and adverse biopsy findings should be offered close follow-up and counselling to minimize further renal deterioration.

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