Abstract: FR-PO1145
Predonation Predictors of Postdonation Kidney Function in Living Kidney Donors: A 24-Month Cohort Study
Session Information
- Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Gopireddy, Naga Sumanth Reddy, University of Iowa Health Care, Iowa City, Iowa, United States
- Ten Eyck, Patrick, University of Iowa Health Care, Iowa City, Iowa, United States
- Thomas, Christie P., University of Iowa Health Care, Iowa City, Iowa, United States
Background
Predicting post-donation renal function in living kidney donors is central to safe donor selection and informed consent, yet the relative contribution of the many preoperative parameters routinely collected during donor evaluation remains poorly defined. We systematically evaluated approximately 58 preoperative variables across six clinical domains to identify which factors offer the greatest independent predictive value for post-donation eGFR at 6, 12, and 24 months.
Methods
We conducted a retrospective cohort study of 438 living kidney donors (January 2010–December 2020). Approximately 58 preoperative variables across six domains: demographics, anthropometrics, renal function, urine markers, metabolic parameters, and CT-based volumetry were evaluated using Pearson correlations, age-adjusted partial correlations, and stepwise multivariable regression. Primary outcomes were eGFR at 6, 12, and 24 months post-donation (CKD-EPI creatinine).
Results
Mean age was 44±12 years; 63.9% female. Despite markedly different pre-donation eGFR (105.1±15.6 vs 92.3±13.8 mL/min/1.73m2, p<0.001), right kidney volume indexed to Body Surfaec Area(BSA) (RtKV/BSA) was identical between donors aged <40 and ≥40 years (82±13 mL/m2 both groups, p=0.917),a structural-functional dissociation confirming that age and kidney volume capture orthogonal dimensions of renal reserve. Post-donation eGFR stabilized at 6 months (64.7±14.3 mL/min/1.73m2) and was maintained through 24 months (66.0±14.0). Backward elimination from 59 candidate variables identified a consistent four-variable optimal model at all three timepoints: baseline eGFR, age, serum creatinine, and RtKV/BSA. Each 10 mL/m2 increment in RtKV/BSA independently associated with +1.81, +1.49, and +2.00 mL/min/1.73m2 higher eGFR at 6, 12, and 24 months respectively (all p≤0.001). Age was the dominant predictor with a growing per-decade effect (−3.10 to −4.43 mL/min), while RtKV/BSA provided independent, sustained structural prediction across all timepoints.
Conclusion
A parsimonious four-variable model: baseline eGFR, age, serum creatinine, and RtKV/BSA, consistently and independently predicts post-donation renal function through 24 months. The dissociation between age-related functional differences and preserved structural kidney volume across age groups supports routine incorporation of BSA-indexed CT volumetry into preoperative living donor evaluation.