Estimated and measured donor creatinine clearance are poor predictors of long-term renal graft function and survival

• The objective of this study was to evaluate estimated and measured donor renal function in predicting graft function long-term and to identify donor criteria associated with nonacceptable graft prognosis. In 200 consecutive cadaver donors creatinine clearance was measured at explantation and estimated using the Cockcroft formula on admission serum creatinine. Graft function was evaluated in recipients (n = 387) by 24-h creatinine clearance regularly during 3years after transplantation. Measured creatinine clearance correlated to some extent with long-term graft function, while Cockcroft estimation was slightly superior and similar to using donor age only. Kidneys from donors with intra-operative creatinine clearance less than or equal to555mL/min (median 50mL/min) produced acceptable recipient graft function of 48mL/min at 3years and 76% 3-year graft survival. Donor age greater than or equal to60years resulted in clearance at 3years of 29mL/min and 78% 3-year graft survival; adding the criteria of admission Cockcroft less than or equal to60mL/min, graft function at 3years (28mL/min) and 3-year graft survival (76%) were similar. In conclusion, creatinine-based estimates of the functional capacity of the donor kidney, calculated or intra-operatively measured, do little to improve the ability of donor age alone to predict long-term allograft function after renal transplantation, and nonacceptable donors are not discriminated.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

kidney transplantation

creatinine clearance

donor renal function

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