Factors influencing the discrepancy between donor and recipient glomerular filtration rate in kidney transplantation

Abstract

THE functional quality of kidneys from cadaveric donors is usually valued by the Cockroft-Gault formula. Recently the importance of the histologic evaluation has been stressed, mainly in marginal donors, but this could sometimes be misleading, due to the focal nature of the sclerotic lesions present in elderly people or to the specimen insufficiency, so Cockroft’s formula remains the pivotal method to measure the donor kidney quality. We wondered if the donor glomerular filtration rate (GFR) could usefully be assumed as the reference value to assess the degree of functional recovery of the graft. We compared the values obtained from the donors with the best values obtained from the recipients during the first year and at 12 months posttransplantation. It is well known that the theoretical identity of these values can be influenced by many factors, including hypertrophy and hyperfiltration from one side, and renal damages of any origins from the other. We considered the donor age, delayed renal function, and acute rejection episodes.