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Living kidney donor evaluation for all candidates with normal estimated GFR for age

F. Gaillard 1, 2 Lola Jacquemont 3 Hélène Lazareth 4 Laetitia Albano 5, 6 Benoit Barrou 7 Nicolas Bouvier 8, 9 Mathias Buchler 10 Dimitri Titeca-Beauport 11 Lionel Couzi 12, 13 Michel Delahousse 14 Didier Ducloux 15 Isabelle Etienne 16 Luc Frimat 17 Cyril Garrouste 18 Denis Glotz 19 Philippe Grimbert 20 Marc Hazzan 21 Alexandre Hertig 22 Maryvonne Hourmant 3 Nassim Kamar 23, 24 Yann Le Meur 25 Moglie Le Quintrec 26, 27 Christophe Legendre 28 Valérie Moal 29, 30 Bruno Moulin 31 Christiane Mousson 32 Claire Pouteil-Noble 33, 34 Philippe Rieu 35 Nacera Ouali 36 Lionel Rostaing 37 Antoine Thierry 38, 39 Fatouma Toure 40 Jonathan Maurice Chemouny 41 Pierre Delanaye 42, 43 Marie Courbebaisse 4, 44 Christophe Mariat 45, 46
Abstract : Multiple days assessments are frequent for the evaluation of candidates to living kidney donation, combined with an early GFR estimation (eGFR). Living kidney donation is questionable when eGFR is <90 ml/min/1.73 m2 (KDIGO guidelines) or 80 ml/min/1.73 m2 (most US centres). However, age-related GFR decline results in a lower eGFR for older candidates. That may limit the number of older kidney donors. Yet, continuing the screening with a GFR measure increases the number of eligible donors. We hypothesized that in-depth screening should be proposed to all candidates with a normal eGFR for age. We compared the evolution of eGFR after donation between three groups of predonation eGFR: normal for age (Sage ) higher than 90 or 80 ml/min/1.73 m2 (S90 and S80, respectively); across three age groups (<45, 45-55, >55 years) in a population of 1825 French living kidney donors with a median follow-up of 5.9 years. In donors younger than 45, postdonation eGFR, absolute- and relative-eGFR variation were not different between the three groups. For older donors, postdonation eGFR was higher in S90 than in S80 or Sage but other comparators were identical. Postdonation eGFR slope was comparable between all groups. Our results are in favour of in-depth screening for all candidates to donation with a normal eGFR for age.
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https://hal.archives-ouvertes.fr/hal-03665050
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Submitted on : Wednesday, May 11, 2022 - 2:01:12 PM
Last modification on : Friday, May 20, 2022 - 11:06:36 AM

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F. Gaillard, Lola Jacquemont, Hélène Lazareth, Laetitia Albano, Benoit Barrou, et al.. Living kidney donor evaluation for all candidates with normal estimated GFR for age. Transplant International, Wiley, 2021, 34 (6), pp.1123-1133. ⟨10.1111/tri.13870⟩. ⟨hal-03665050⟩

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