2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2004030209v1 16/1/261    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Giral, M. Articles by Soulillou, J. P. Search for Related Content PubMed PubMed Citation Articles by Giral, M. Articles by Soulillou, J. P.

Impact of Graft Mass on the Clinical Outcome of Kidney Transplants

Magali Giral^*, Jean Michel Nguyen, Georges Karam, Michelle Kessler, Bruno Hurault de Ligny^||, Mattias Buchler^¶, François Bayle^#, Carole Meyer^**, Yohann Foucher, Marie Laure Martin, Pascal Daguin^* and Jean Paul Soulillou^*

^* Institut de Transplantation Et de Recherche en Transplantation and INSERM U437 (Immunointervention dans les Allo et Xénotransplantation), Nantes; Service de Biostatistique, Pôle d’Information Médicale d’Evaluation et de Santé Publique, Saint Jacques Hospital, Nantes University Hospital, Nantes; Service d’urologie, Place Alexis Ricordeau, Nantes; Service de néphrologie, CHU, Nancy; ^|| Service de néphrologie, Caen; ^¶ Service de néphrologie, Tours; ^# Service de néphrologie, Grenoble; and ^** Service de néphrologie, Strasbourg, France

Address correspondence to: Dr. Jean Paul Soulillou, Institut de Transplantation et de Recherche en Transplantation and Inserm U437 (Immunointervention dans les Allo et Xénotransplantation), 30 bd Jean Monnet, 44093, Nantes, France. Phone: 33-2-40-08-74-10; Fax: 33-2-40-08-74-11; jps{at}nantes.inserm.fr

The effect of nephronic mass reduction of kidney transplants has not been analyzed specifically in a large cohort. Transplant injuries in cadaver kidney graft may have led to an underestimation of the magnitude of this factor. The aim of this study was to analyze the consequences of kidney mass reduction on transplantation outcome. The weights of 1142 kidney grafts were collected prospectively immediately before grafting. Donors and recipients <15 yr of age, simultaneous kidney/pancreas grafts, and technical failures before day 7 were excluded from the analysis. The analysis was performed on Cockroft-calculated creatinine clearance and proteinuria in 964 patients for whom all of the necessary information was available. This study reports that the smallest kidneys transplanted into the largest recipients (donor kidney weight/recipient body weight [DKW/RBW] <2 g/kg, n = 88) increased their clearance by 2.38 ml/min every month for 6 mo (P < 0.0001) and by 0.27 ml/min thereafter (P < 0.0001). Conversely, creatinine clearance did not change for the largest kidneys transplanted into the smallest recipients (DKW/RBW ratios 4 g/kg). Next, using a Cox model analysis, it was shown that the risk of having a proteinuria >0.5 g/kg was significantly increased for the low DKW/RBW ratios <2 g/kg with 50% of patients having a proteinuria, compared with DKW/RBW ratios 4 g/kg (P < 0.001). In cadaver transplant recipients, graft mass has a rapid impact on graft filtration rate and proteinuria. Avoiding major kidney/recipient inadequacy should have a significant influence on long-term transplant function.

This article has been cited by other articles:

				J. Ashton-Chess, M. Giral, M. Mengel, K. Renaudin, Y. Foucher, W. Gwinner, C. Braud, E. Dugast, T. Quillard, P. Thebault, et al. Tribbles-1 as a Novel Biomarker of Chronic Antibody-Mediated Rejection J. Am. Soc. Nephrol., June 1, 2008; 19(6): 1116 - 1127. [Abstract] [Full Text] [PDF]

				J. B. Douverny, J. C. Baptista-Silva, J. O. M. Pestana, and R. Sesso Importance of renal mass on graft function outcome after 12 months of living donor kidney transplantation Nephrol. Dial. Transplant., December 1, 2007; 22(12): 3646 - 3651. [Abstract] [Full Text] [PDF]

				K.-Y. Kang, Y. J. Lee, S. C. Park, C. W. Yang, Y.-S. Kim, I. S. Moon, Y. B. Koh, B. K. Bang, and B. S. Choi A comparative study of methods of estimating kidney length in kidney transplantation donors Nephrol. Dial. Transplant., August 1, 2007; 22(8): 2322 - 2327. [Abstract] [Full Text] [PDF]

				J.-P. Soulillou and M. Giral Influence of graft characteristics on the outcome of kidney transplantation. N. Engl. J. Med., May 11, 2006; 354(19): 2060 - 2062. [Full Text] [PDF]

				K. Zandi-Nejad, V. A. Luyckx, and B. M. Brenner Adult Hypertension and Kidney Disease: The Role of Fetal Programming Hypertension, March 1, 2006; 47(3): 502 - 508. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673