Fate of kidneys from the same donor grafted into different recipients: do they behave similarly and are they influenced by donor-related factors?

Background: The fate of paired kidneys might be similar and could therefore reflect the influence of donor-related factors on graft outcome. Patients and Methods: To verify whether two kidneys retrieved from a single donor and grafted into different recipients have similar short, and middle -term outcomes we investigated the clinical outcome of 103 pairs of cadaver ic kidneys grafted into 206 recipients. We evaluated the influence of donor -related factors such as age, sex and cause of death, and of the storage so lution and method of harvesting. The incidence of delayed graft function wa s considered as the short-term outcome and serum creatinine levels at two y ears as the middle-term outcome. We evaluated the difference from expected frequencies in the incidence of delayed graft function and the incidence of similar serum creatinine levels in each pair of recipients. Univariate analysis of possible risk factors was made by the t-test, chi(2) test and Fisher test, as appropriate. Multivariate analysis was done by lo gistic regression analysis with a forward stepwise variable selection. Results: Delayed graft function was seen in both recipients from the same d onor 2.5 times more than the expected frequency (p < 0.001). Serum creatini ne levels were similar in both recipients with a higher frequency than expe cted (p < 0.01). Multivariate analysis showed that donor-related factors on graft function were age, cause of death and storage solution. Conclusions: Paired kidneys have similar performances in both the short and the long term. Major donor-related factors in delayed graft function are a ge and the storage solution. Major donor-related factors in graft function are age and cause of death.