The perfusion pressure in non-heart-beating donors may expand the glomeruli.
INTRODUCTION: We have observed expanded glomeruli in biopsies of kidneys from non-heart-beating donors (NHBDs). We sought to determine the differences in glomerular size between NHBDs and brain-dead donors and to assess whether glomerular size impacted graft outcome. METHODS: We estimated the glomerular area using the maximal planar area (MPA) method in 198 pretransplant biopsies from 119 donors: 54 (45.4%) NHBDs and 65 (54.6%) brain-dead donors. Donor data and graft outcomes were correlated with MPA and percentage of glomerulosclerosis. The range of follow-up was 1 to 3 years. Uni- and multivariate analyses were performed. RESULTS: MPA was larger among NHBDs. MPA and GS both significantly correlated with donor age. The association between MPA and age was independent of nephron loss (ie; GS). Increased glomerular size was only observed among donors younger than 50 years. Graft survival and function were not independently associated with MPA. Donor age was a better predictor of graft outcome. CONCLUSIONS: The perfusion pressure used in NHBDs may expand the glomeruli, but this maneuver does not have any effect on graft outcome. Among donors without severe changes, glomerular size increment shows a limit around the sixth decade of life. In our study, MPA was not an independent predictor of graft survival or function.