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

Background To examine the association of preoperative Mayo Adhesive Probability (MAP) scores in the donor (MAP(d)) and non-donor kidneys (MAP(nd)) with post-donation renal function. Methods Three hundred thirty-one patients undergoing hand assisted laparoscopic donor nephrectomy (HALDN) were reviewed. MAP(d)and MAP(nd)were obtained. Estimated glomerular filtration rate (eGFR) was recorded preoperatively and at 1 day, 1 month, and 6 months postoperatively. Results Two hundred females and 131 males were evaluated with median BMI 26.4 kg/m(2)(range 17.1-39.6) and median age 45 years (range 19-78). MAP(d)score was 0 for 231 patients (69.8%) and > 0 for 100 patients (30.2%). MAP(nd)score was 0 for 234 patients (70.7%) and > 0 for 97 patients (29.3%). The median preoperative eGFR was 86.6 ml/min/1.73m(2)(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 MAP(nd) = 0, donors with a MAP(nd) > 0, mean eGFR was - 2.33 ml/min/1.73m(2)lower at postoperative day 1 (95% CI - 4.24 to - 0.41,p = 0.018), - 3.02 ml/min/1.73m(2)lower at 1 month (95% CI - 5.11 to - 0.93,p = 0.005), and - 2.63 ml/min/1.73m(2)lower at 6 months postoperatively (95% CI - 5.01 to - 0.26,p = 0.030). Conclusions MAP score > 0 in the non-donated kidney is associated with worse renal function in the 6 months following HALDN.