Effects on Contralateral Kidney after Living Donor Nephrectomy

Background: After live donor nephrectomy (LDN) there is compensatory hypertrophy in contralateral kidney. Aim: In this study we investigated effects of neprectomy on the contralateral kidney. Effects on contralateral kidney studied in this study are renal parenchymal volume (RPV), glomerular filtration rate and renal function tests Method: From July 2010 and January 2014, 517 live related kidney transplants were done at Sharif Medical and Dental College, Department of Urology and Renal transplantation, Lahore of which 500 kidney donors were enrolled in this study. Renal parenchymal volume (RPV) was calculated by ultrasonograghy (U/S) and U/S was done before surgery,07 days, 3 months and one year postoperatively. Technetium 99m Diethylene Triamine Penta Acetic acid (DTPA)scan was used for measurement of glomerular filtration rate (GFR).DTPA scan was performed before surgery,03 months and 01 year postoperatively. The function of the contralateral kidney was assessed by doing blood serum test (RFTs) which was done before surgery,03 day, 7 day and 01 year postoperatively. Results: The RPV of the contralateral kidney was 163 +/- 29.7 cm(3) before surgery and then increased by 21.23% to 195.5 +/- 39.9cm(3) 07 days, by 24.17% to 146.60 +/- 25.86cm(3) at 3 months and by 26.1% to 196.4 +/- 38.0cm(3) at one year. In this study, we also found that those contralateral kidney who got smaller size before surgery compared to donor kidney achieved bigger gain in size in the post-operative period (p=0.005).Those contralateral kidneys who achieved =20% increase in RPV,07 day postoperatively are more likely to show further increase in GFR at 01 year (p=0.024). Conclusions: After donor nephrectomy there is immediate increase in PRV of the contralateral kidney with icrease in GFR. Initially there is increase in SCr but within normal range. Study of these effects on contralateral kidney after donor nephrectomy favours the live kidney donor transplant.