2013 - ISODP 2013 Congress

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Mini-Oral 3 Technical Advances

10.11 - Prognostic impact of kidney volume and early kidney resistance index on graft and patient survival in 1-year observation.

Presenter: Anita, Sierocka, Szczecin, Poland
Authors: Anita Sierocka, Jan Pawlus, Tadeusz Sulikowski, Karol Tejchman, Marek Ostrowski, Maciej Romanowski, Kazimierz Ciechanowski, Jerzy Sieńko, Maciej Żukowski, Aleksander Falkowski

Prognostic impact of kidney volume and early kidney resistance index on graft and patient survival in 1-year observation.

Anita Sierocka1, Jan Pawlus1, Tadeusz Sulikowski1, Karol Tejchman1, Marek Ostrowski1, Maciej Romanowski1, Kazimierz Ciechanowski2, Jerzy Sieńko1, Maciej Żukowski3, Aleksander Falkowski4

1Department of General Surgery and Transplantation, Pomeranian Medical University , Szczecin, Poland, 2Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Faculty of Medicine, Szczecin, Poland, 3Clinic of Anaesthesiology and Intensive Care, Pomeranian Medical University, Faculty of Medicine, Szczecin, Poland, 4II Department of Radiological Diagnostics , Pomeranian Medical University, Faculty of Medicine, Szczecin, Poland

Background:Resistance index (RI) is measured by Doppler sonography during the early posttransplant period. RI reflects vascular susceptibility connected with interstitial kidney oedema. RI>0,8 is identified as a powerfull predictor for worse kidney function[1,2,3]. Kidney graft volume seem to have importance in a matter of adjusting number of active nephrons to the recipient. However mentioned correlation was confirmed by only a few publications [4]. There are allocation protocols which includes adjusting kidney mass to the body weight of the recipient, neverthelles those procedures seem not to have sufficient scientific confirmation.

Aim:The aim of this study was to evaluate the correlation between kidney volume as well as early kidney resistance index (RI) and graft outcome and patient survival.

Material and methods:66 recipients were included to the study. Kidney volume was determined before graft implantation, RI was measured in the first day after surgery. Statistical analysis was performed to adjust for demographic and clinical variables. Statistical significance was analised with T-Student test and Spearman-R correlation (p<0,05).

Results: Kidney volume (Vk) was correlated with graft function, acute rejection episodes (AR), eGFR and graft survival with no statistical significance. We observed statistical significance between Vand diuresis 1 month after transplantation (Tx) (p=.01). There was significant correlation between RI and DGF (p=.02), AR (p=.02), diuresis during 1 week after Tx (p<.05), creatinine during 1 month after Tx (p<.05) and eGFR 3 month after Tx (p=.0009). 

Conclusion:Vk has no influence on graft function. Higher RI values in the early post-transplant period are correlated with higher DGF occurence, higher AR episodes occurence 1 year after Tx, higher creatinine serum concentration 1 month after TX, lower eGFR 3 month after Tx.

Source of Funding:NCN:2013/B/P01/2011/40

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