Mayo Adhesive Probability (MAP) score of non-donated kidney aids in predicting post-operative renal function following donor nephrectomy

Katherine J Cockerill,Martin L Mai,Colleen T Ball,C Burcin Taner,Amanda E Kahn,David D Thiel,Stacy M Young,Dana K Perry

doi:10.1186/s12894-020-00695-2

Katherine J Cockerill, Martin L Mai + Show 6 more

Open Access

https://doi.org/10.1186/s12894-020-00695-2

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Journal: BMC Urology	Publication Date: Aug 17, 2020
Citations: 2	License type: open-access

Affiliation: Mayo Clinic, Winneshiek Medical Center

Abstract

BackgroundTo examine the association of preoperative Mayo Adhesive Probability (MAP) scores in the donor (MAPd) and non-donor kidneys (MAPnd) with post-donation renal function.MethodsThree hundred thirty-one patients undergoing hand assisted laparoscopic donor nephrectomy (HALDN) were reviewed. MAPd and MAPnd were obtained. Estimated glomerular filtration rate (eGFR) was recorded preoperatively and at 1 day, 1 month, and 6 months postoperatively.ResultsTwo hundred females and 131 males were evaluated with median BMI 26.4 kg/m2 (range 17.1–39.6) and median age 45 years (range 19–78). MAPd score was 0 for 231 patients (69.8%) and > 0 for 100 patients (30.2%). MAPnd score was 0 for 234 patients (70.7%) and > 0 for 97 patients (29.3%). The median preoperative eGFR was 86.6 ml/min/1.73m2 (range 48.8–138.4). After adjusting for preoperative eGFR, BMI, ASA score, and kidney sidedness, postoperative eGFR was associated with MAP score in the non-donated kidney (p = 0.014) but not in the donated kidney (p = 0.24). Compared to donors with MAPnd = 0, donors with a MAPnd > 0, mean eGFR was − 2.33 ml/min/1.73m2 lower at postoperative day 1 (95% CI − 4.24 to − 0.41, p = 0.018), − 3.02 ml/min/1.73m2 lower at 1 month (95% CI − 5.11 to − 0.93, p = 0.005), and − 2.63 ml/min/1.73m2 lower at 6 months postoperatively (95% CI − 5.01 to − 0.26, p = 0.030).ConclusionsMAP score > 0 in the non-donated kidney is associated with worse renal function in the 6 months following HALDN.

Highlights

To examine the association of preoperative Mayo Adhesive Probability (MAP) scores in the donor (MAPd) and non-donor kidneys (MAPnd) with post-donation renal function
After adjusting for preoperative Estimated glomerular filtration rate (eGFR), body mass index (BMI), American Society of Anesthesiologists score (ASA) score, and kidney sidedness, postoperative eGFR was associated with MAP score in the non-donated kidney (p = 0.014) but not in the donated kidney (p = 0.24)
Compared to donors with Non-donated kidneys (MAPnd) = 0, donors with a MAPnd > 0, mean eGFR was − 2.33 ml/min/1.73m2 lower at postoperative day 1, − 3.02 ml/min/1.73m2 lower at 1 month, and − 2.63 ml/min/1.73m2 lower at 6 months postoperatively

Summary

Introduction

To examine the association of preoperative Mayo Adhesive Probability (MAP) scores in the donor (MAPd) and non-donor kidneys (MAPnd) with post-donation renal function. Adherent perinephric fat (APF) has been associated with surgical complexity and longer operative times in patients undergoing partial nephrectomy [10]. Higher MAP score has previously been shown to be associated with longer operative time in patients undergoing hand-assisted laparoscopic donor nephrectomy [13]. MAP score components (perinephric fat area and stranding) were correlated with the presence of APF during donor nephrectomy [14]. Motivated by these findings, we examined the relationship between MAP score and postdonation renal function in healthy patients undergoing hand-assisted laparoscopic donor nephrectomy (HALD N)

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