Comparing outcomes in right versus left kidney transplantation: A systematic review and meta-analysis
- PMID: 34496090
- DOI: 10.1111/ctr.14475
Comparing outcomes in right versus left kidney transplantation: A systematic review and meta-analysis
Abstract
Introduction: Transplantation of right kidneys can pose technical challenges due to the short right renal vein. Whether this results in inferior outcomes remains controversial.
Method: Healthcare Database Advanced Search (HDAS) was used to identify relevant studies. Two authors independently reviewed each study. Statistical analyses were performed using random effects models and results expressed as HR or relative risk (RR) with 95% confidence intervals. Subgroup analyses were performed in kidneys from deceased donors (DD) and living donors (LD).
Results: A total of 35 studies (257,429 participants) were identified. Both deceased and living donor right kidneys were at increased risk of delayed graft function (DGF; RR = 1.12[1.06-1.18] and RR = 1.33[1.21-1.46] respectively; both p < .0001). In absolute terms, for each 100 kidney pairs of DD kidneys transplanted there are 2.72 (1.67-3.78, p < .00001) excess episodes of DGF in right kidneys. Graft thromboses and graft loss due to technical failure was also significantly more likely in right kidneys, in both DD and LD settings. There was no evidence that laterality alters long term graft survival in LD or DD.
Conclusion: Right kidneys have inferior early outcomes, with higher rates of DGF, technical failure and graft thrombosis. However, these differences are small in absolute terms, and long-term graft survival is equivalent.
Keywords: deceased donor; graft; kidney; living donor; recipient outcomes; right versus left; transplant.
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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References
REFERENCES
-
- Woodroffe R, Yao GL, Meads C, et al. Clinical and cost-effectiveness of newer immunosuppressive regimens in renal transplantation: a systematic review and modelling study. Health Technol Assess. 2005;9(21):1-179. https://doi.org/10.3310/hta9210.
-
- OPTN/SRTR 2018 Annual Data Report: Kidney. Scientific Registry of Transplant Recipients website. https://srtr.transplant.hrsa.gov/annual_reports/2018/Kidney.aspx#KI_78_t... Accessed October 10, 2020.
-
- Global observatory on donation and transplant website. http://www.transplant-observatory.org/summary/ Accessed October 10, 2020.
-
- Mandal AK, Cohen C, Montgomery RA, Kavoussi LR, Ratner LE. Should the indications for laparoscopic live donor nephrectomy of the right kidney be the same as for the open procedure? Anomalous left renal vasculature is not a contraindication to laparoscopic left donor nephrectomy. Transplantation. 2001;71(5):660-664.
-
- Khalil A, Mujtaba MA, Taber TE, et al. Trends and outcomes in right vs. left living donor nephrectomy: an analysis of the OPTN/UNOS database of donor and recipient outcomes-should we be doing more right-sided nephrectomies?. Clin Transplant. 2016;30(2):145-153. https://doi.org/10.1111/ctr.12668.
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