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Kidney Week

Abstract: PO2414

Glomerular Blood Flow in Living Donor Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Kanzaki, Go, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Sasaki, Takaya, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Haruhara, Kotaro, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Oba, Rina, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Okabayashi, Yusuke, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Koike, Kentaro, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Kobayashi, Akimitsu, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Yamamoto, Izumi, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Tsuboi, Nobuo, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Yokoo, Takashi, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
Background

Renal graft hemodynamics may be a valuable predictor of graft survival and long-term outcomes. Although several studies have reported that renal blood flow was correlated with graft function and decreased remarkably during acute rejection episode, the glomerular hemodynamic changes during kidney transplantation are lacking because there is no method of measuring nephron number in vivo. In this study, we calculate glomerular blood flow (GBF) by estimating the nephron number and investigate changes in GBF after kidney transplantation and their clinicopathological relationship.

Methods

We performed a retrospective analysis of 42 patients who underwent living donor kidney transplantation. The number of glomeruli (Nglom) was calculated as the cortical volume of both kidneys as assessed on computed tomography times the 1-hour posttransplant renal biopsy-determined glomerular density. Effective renal plasma flow (ERPF) was assessed as 99mTc-MAG3 clearance. GBF was calculated as follows: GBF (nl/min) = ERPF/Nglom/(1-hematocrit/100) x106. We analyzed the GBF before and during a 1-month observation period after transplantation. The GBF ratio as a marker of change in GBF was calculated as follows: (GBF one-month post-transplantation) / (GBF before transplantation in donors).

Results

Prior to transplantation, the GBF in donors was 559.7±257.3 nl/min, whereas the GBF in recipients on day 2 post-transplantation was decreased to 502.6±317.4 nl/min. After successful transplantation, the GBF one-month post-transplantation has settled down to 491.9±291.1 nl/min, while the eGFR progressively rose (48.7±18.4 ml/min/1.73m2) together with the hematocrit (31.1±3.9 %). The GBF at one month was positively associated with eGFR at one month (p<0.05). Of note, the GBF ratio was correlated with the eGFR and urinary protein execration at one month and urinary protein execration at 1 year but was not correlated with eGFR at 1 yr.

Conclusion

We first reported the GBF in kidney transplant recipients before and after kidney transplantation. Our findings suggest that abnormal change in GBF may be considered predictive indices for short-term allograft outcomes.