Project overview
This retrospective study assessed 244 living donor kidney transplants to examine how the donor kidney volume-to-recipient body surface area (Vol/BSA) ratio influences graft outcomes. Donor kidney volume was measured using preoperative CT scans, while recipient BSA was calculated via the Mosteller formula. The Vol/BSA ratio was found to be an independent predictor of 12-month estimated glomerular filtration rate (eGFR), alongside recipient age and sex. Recipients in the highest Vol/BSA tertile had significantly better graft function (mean eGFR 75.95 mL/min/1.73 m²) compared to those in lower tertiles. Despite no significant difference in complication rates such as rejection or delayed graft function, the study supports the concept of “nephron dosing,” suggesting that larger donor kidneys relative to recipient size improve metabolic balance and reduce hyperfiltration risk.
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