Background: Kidney transplantation remains the gold standard treatment option for end stage renal disease (ESRD) patients worldwide. Renal allografts from living donor alleviates the pain and quality of life of ESRD patients. In under-developed countries like Nigeria, where deceased-donor program is currently not available, living donors comprise the entirety of the kidney donor population. Long term effect of hyperfiltration occurring in donor residual kidney remains controversial.
Objectives: To evaluate the ultrasonographic changes in the renal artery in kidney transplant donors following donor nephrectomy.
Method: This study was a prospective, cross-sectional study that assessed the haemodynamic changes before and after nephrectomy in the remnant kidney of living donors of ESRD patients.
Consenting adults were recruited using a convenient sampling strategy. Their renal indices were evaluated using a logic e10 General Electric (GE) ultrasound machine. The resistivity index (RI), peak systolic velocity (PSV), and end diastolic velocity (EDV) were measured before, 3 days after and 10 days after nephrectomy. The measurements were entered into and analysed using Statistical Packages for Social Sciences.
Results: Fifty-four (54) donors consented to participate in the study and were recruited. The mean RI, PSV and EDV before donor nephrectomy were 0.641 ± 0.09, 70.71 ± 14.52cm/s, and 29.84 ± 8.96cm/s respectively. Three days after donor nephrectomy, mean RI, PSV and EDV were 0.6409 ± 0.09, 74.18 ± 11.53cm/s (p < 0.05*), and 37.36 ± 8.65cm/s respectively. The results for mean RI, PSV and EDV were 0.6391 ± 0.09, 76.61 ±12.09cm/s, and 31.58 ± 8.24cm/s respectively, 10 days post donor nephrectomy. There was significant increase in dimension height of the kidney three days post donor nephrectomy (5.6359 ± 0.78 vs. 5.7291 ± 0.81 [p<0.05]).
Conclusion: There are statistically significant changes in main peak systolic velocity and dimension height seen with doppler ultrasonography shortly after donor nephrectomy. This may be due to compensatory mechanisms in the early post-operative period.