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Observational Study
. 2022 Mar 18:35:10253.
doi: 10.3389/ti.2022.10253. eCollection 2022.

Impact of Size Matching Based on Donor-Recipient Height on Kidney Transplant Outcomes

Srijan Tandukar  1 , Christine Wu  2 , Sundaram Hariharan  2 , Chethan Puttarajappa  2
Affiliations
Observational Study

Impact of Size Matching Based on Donor-Recipient Height on Kidney Transplant Outcomes

Srijan Tandukar et al. Transpl Int. .

Abstract

Transplantation of kidneys from shorter donors into taller recipients may lead to suboptimal allograft survival. The effect of discrepancy in donor and recipient heights (ΔHeight) on long term transplant outcomes is not known. Adult patients ≥18 years undergoing living or deceased donor (LD or DD) kidney transplants alone from donors ≥18 years between 2000 and 2016 in the United States were included in this observational study. The cohort was divided into three groups based on ΔHeight of 5 inches as 1) Recipient < Donor (DD: 31,688, LD: 12,384), 2) Recipient = Donor (DD: 84,711, LD: 54,709), and 3) Recipient > Donor (DD: 21,741, LD: 18,753). Univariate analysis showed a higher risk of DCGL and mortality in both DD and LD (p < 0.001 for both). The absolute difference in graft and patient survival between the two extremes of ΔHeight was 5.7% and 5.7% for DD, and 0.4% and 1.4% for LD. On multivariate analysis, the HR of DCGL for Recipient < Donor and Recipient > Donor was 0.95 (p = 0.05) and 1.07 (p = 0.01) in DD and 0.98 (p = 0.55) and 1.14 (p < 0.001) in LD. Similarly, the corresponding HR of mortality were 0.97 (p = 0.07) and 1.07 (p = 0.003) for DD and 1.01 (p < 0.001) and 1.05 (p = 0.13) for LD. For DGF, the HR were 1.04 (p = 0.1) and 1.01 (p = 0.7) for DD and 1.07 (p = 0.45) and 0.89 (p = 0.13) for LD. Height mismatch between the donor and recipient influences kidney transplant outcomes.

Keywords: SRTR; height mismatch; kidney transplantation; size mismatch; weight mismatch.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Algorithm showing derivation of patient cohorts for analysis.
FIGURE 2
FIGURE 2
Kaplan Meier curves showing differences in death censored graft loss with incremental difference between recipient and donor heights [Height of recipient (R) shorter than (<) or taller than (>) donor (D) by more than 5 inches, or within 5 inches (=)]. (A) Deceased donor, p < 0.001. (B) Living donor, p < 0.001.
FIGURE 3
FIGURE 3
Differences in death censored graft loss with incremental differences in recipient and donor heights. [Height of recipient (R) shorter than (<) or taller than (>) donor (D) by more than 5 inches, or within 5 inches (=)]. (A) Deceased donor kidney transplant. (B) Living donor kidney transplant.
FIGURE 4
FIGURE 4
Kaplan Meier curves showing differences in mortality with incremental difference between recipient and donor heights [Height of recipient (R) shorter than (<) or taller than (>) donor (D) by more than 5 inches, or within 5 inches (=)]. (A) Deceased donor transplants, p < 0.001. (B) Living donor transplants, p < 0.001.
FIGURE 5
FIGURE 5
Differences in mortality with incremental differences in recipient and donor height and weight. [Height of recipient (R) shorter than (<) or taller than (>) donor (D) by more than 5 inches, or within 5 inches (=)]. (A) Deceased donor transplant. (B) Living donor transplant.
FIGURE 6
FIGURE 6
Differences in delayed graft function with incremental differences in recipient and donor height and weight. [Height of recipient (R) shorter than (<) or taller than (>) donor (D) by more than 5 inches, or within 5 inches (=)]. (A) Deceased donor transplants. (B) Living donor transplants.
FIGURE 7
FIGURE 7
Differences in death censored graft loss with incremental differences in recipient and donor heights, categorized on the basis of gender differences between the donor-recipient pairs. [Height of recipient (R) shorter than (<) or taller than (>) donor (D) by more than 5 inches, or within 5 inches (=)]. (A) Deceased donor male to male transplant. (B) Deceased donor female to female transplant. (C) Deceased donor female to male transplants. (D) Deceased donor male to female transplant. (E) Living donor male to male transplants. (F) Living donor female to female transplant. (G) Living donor female to male transplant. (H) Living donor male to female transplant.
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