[citation report] The differential impact of size mismatch in live versus deceased donor kidney transplant

Cited by 2 publications

(5 citation statements)

References 19 publications

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“…Our analysis demonstrates an attenuation of the protective effects of a larger donor than recipient ( 16 , 17 , 18 , 19 , 20 , 24 , 55 ) when either the donor or recipient is obese. This finding may similarly be explained by the nephron underdosing hypothesis ( 39 , 56 ) whereby the relatively smaller renal mass in smaller donors results in increased single nephron glomerular filtration rate and increased risk of hyperfiltration injury over time ( 34 , 38 , 57 , 58 , 59 ).…”

Section: Discussionmentioning

confidence: 70%

“…A secondary exposure was combined donor and/or recipient obesity and DR weight mismatch. We categorized DR absolute weight difference as >30 kg, 10-30 kg (donor < recipient, D<R; or donor > recipient, D>R) and <10 kg (D = R) as per previous literature ( 19 ), stratified by the four aforementioned DR obesity pairings (NOD-NOR, OD-NOR, NOD-OR and OD-OR).…”

Section: Methodsmentioning

confidence: 99%

“…No studies to date have assessed the potential interaction between donor and recipient obesity on graft outcomes. Importantly, weight mismatch between kidney donors and recipients (DR) has been shown to associate with graft outcomes; recipients receiving organs from relatively smaller donors experience significantly worse outcomes than those receiving kidneys from weight-matched or larger donors ( 19 , 20 , 21 , 22 , 23 ). However, whether donor and/or recipient obesity modifies the association between DR weight mismatch and transplant outcomes has not been previously examined.…”

Section: Introductionmentioning

confidence: 99%

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Combined Donor-Recipient Obesity and the Risk of Graft Loss After Kidney Transplantation

Jarrar¹,

Tennankore

Vinson

2022

Transpl Int

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Background: As the prevalence of obesity increases globally, appreciating the effect of donor and recipient (DR) obesity on graft outcomes is of increasing importance.Methods: In a cohort of adult, kidney transplant recipients (2000–2017) identified using the SRTR, we used Cox proportional hazards models to examine the association between DR obesity pairing (body mass index (BMI) >30 kg/m2), and death-censored graft loss (DCGL) or all-cause graft loss, and logistic regression to examine risk of delayed graft function (DGF) and ≤30 days graft loss. We also explored the association of DR weight mismatch (>30 kg, 10-30 kg (D>R; D<R) and <10 kg (D = R)) with each outcome, stratifying by DR obesity pairing.Results: Relative to non-obese DR, obese DR were highest risk for all outcomes (DCGL: HR 1.26, 95% CI 1.22–1.32; all-cause graft loss: HR 1.09, 95% CI 1.06–1.12; DGF: OR 1.98, 95% CI 1.89–2.08; early graft loss: OR 1.34, 95% CI 1.19–1.51). Donor obesity modified the risk of recipient obesity and DCGL [p = 0.001] and all-cause graft loss [p < 0.001] but not DGF or early graft loss. The known association of DR weight mismatch with DCGL was attenuated when either the donor or recipient was obese.Conclusion: DR obesity status impacts early and late post-transplant outcomes.

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Section: Discussionmentioning

confidence: 70%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Combined Donor-Recipient Obesity and the Risk of Graft Loss After Kidney Transplantation

Jarrar¹,

Tennankore

Vinson

2022

Transpl Int

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“…Prior studies have evaluated size mismatch between the recipient and donor on the basis of body surface area (BSA), body mass index (BMI), and weight (2,3,8,9). These parameters have been used as surrogates for discrepancies in kidney size and/ or nephron mass in the recipient-donor pair.…”

Section: Discussionmentioning

confidence: 99%

“…Gender differences are also an important factor to consider when assessing size mismatch (8,9,17,18). We found that the influence of height discrepancies persisted within different combinations of donor-recipient genders in a predictable pattern just as in the overall cohort of DD and LD transplants.…”

Section: Discussionmentioning

confidence: 99%

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

Tandukar

Hariharan

et al. 2022

Transpl Int

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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.

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The differential impact of size mismatch in live versus deceased donor kidney transplant

Cited by 2 publications

References 19 publications

Combined Donor-Recipient Obesity and the Risk of Graft Loss After Kidney Transplantation

Combined Donor-Recipient Obesity and the Risk of Graft Loss After Kidney Transplantation

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

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