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      Effect of Donor/Recipient Body Weight Mismatch on Patient and Graft Outcome in Living-Donor Kidney Transplantation

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          Background/Aims: There have been conflicting reports showing that kidneys from small donors may be at risk for graft loss if they are transplanted into large recipients. The aim of this work was to examine the donor/recipient body weight ratio (D/RBWR) on patient and graft outcome. Methods: During the period from January 1990 to January 2002, 856 kidney transplants were performed. Of these, 776 kidney transplant recipients were selected after exclusion of pediatric, second transplant patients and those with a body mass index of ≧35. All patients achieved a minimum follow-up of 1-year. According to D/RBWR, patients were divided into 3 groups: low (≤0.9), medium (0.91–1.2) and high (≧1.2). Data were collected on graft function, acute and chronic rejection, post-transplant complications, and 1- and 5-year graft and patient survival. Results: There was a statistically significant increase in the incidence of chronic rejection, post-transplant hypertension and diabetes mellitus in the low group. The incidence and frequency of acute rejection episodes were nearly the same in the 3 groups. Graft function, estimated by serum creatinine at 1 year, was significantly lower in the low group. The 5-year graft and patient survival was 71, 80, 88 and 81, 85 and 92%, in the low, medium and high groups, respectively. Conclusions: We conclude that a low D/RBWR may contribute to inferior long-term renal allograft survival. The hyperfiltration hypothesis due to low nephron mass in the low D/RBWR group may explain these findings.

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          Most cited references 7

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          Obesity does not portend a bad outcome for kidney transplant recipients.

          Kidney transplant programs may avoid transplantation in obese patients because of reports indicating that obese patients have poorer outcomes than do nonobese patients. We recently reviewed our experience.
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            Impact of donor nephron mass on outcomes in renal transplantation.

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                Author and article information

                Am J Nephrol
                American Journal of Nephrology
                S. Karger AG
                October 2003
                08 September 2003
                : 23
                : 5
                : 294-299
                Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
                72819 Am J Nephrol 2003;23:294–299
                © 2003 S. Karger AG, Basel

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                Page count
                Tables: 5, References: 22, Pages: 6
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/72819
                Original Article: Patient-Oriented, Translational Research

                Cardiovascular Medicine, Nephrology

                Living donor, Weight, Kidney transplantation


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