NDT Advance Access originally published online on May 30, 2006
Nephrology Dialysis Transplantation 2006 21(9):2583-2588; doi:10.1093/ndt/gfl268
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Original Articles: Dialysis and Transplantation
Deceased donor renal transplantation—does side matter?
Queensland Renal Transplant Service, University of Queensland, Princess Alexandra Hospital, Brisbane, QLD, Australia
Correspondence and offprint requests to: Prof. David W. Johnson, Department of Renal Medicine, Level 2, Ambulatory Renal and Transplant Services Building, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane Qld 4102, Australia. Email: david_johnson{at}health.qld.gov.au
Background. The aim of the present study was to determine whether the deceased donor kidney side (left or right kidney) was predictive of subsequent kidney transplant outcomes.
Methods. A retrospective analysis was undertaken of the left–right deceased donor kidney pairs transplanted into recipients with end-stage renal failure in Queensland between 1 April 1994 and 31 March 2004.
Results. A total of 201 left–right deceased donor kidney pairs were transplanted into 402 patients. The baseline characteristics of the recipients in the two groups were comparable, except that the patients receiving right kidneys had lower body mass indices and shorter cold ischaemic times. No differences were seen between the left and right kidney recipient groups with respect to operative duration (3.02 ± 0.67 vs 3.12 ± 0.72 h, P = 0.16), warm ischaemic time (0.62 ± 0.18 vs 0.65 ± 0.21, P = 0.09), delayed graft function (4 vs 6%, respectively, P = 0.26) or a composite vascular, haemorrhagic, ureteric and infective post-operative complication end-point (22 vs 22%, P = 0.90). Estimated glomerular filtration rates were almost identical at 1 month (52.7 ± 39.6 vs 51.0 ± 24.0 ml/min/1.73 m2, P = 0.34) and remained comparable thereafter. Respective death-censored graft survival rates for left and right kidney recipients were 100 and 100% at 1 year, 99.4 and 96.4% at 3 years and 96.3 and 95.5% at 5 years, respectively (P = 0.67).
Conclusions. Although left and right deceased donor kidneys present different operative challenges, the present results suggest that the probability of early post-operative complications, delayed graft function, impaired early and medium-term renal allograft function or death-censored graft failure is comparable between left and right kidney recipients.
Keywords: delayed graft function; graft survival; kidney transplantation; left kidney; post-operative complications; right kidney
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