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Comparing outcomes in right versus left kidney transplantation: A systematic review and meta-analysis

Lookup NU author(s): Dr Sam Tingle, Emily Thompson, Gourab Sen, Professor Colin Wilson


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© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Introduction: Transplantation of right kidneys can pose technical challenges due to the short right renal vein. Whether this results in inferior outcomes remains controversial. Method: Healthcare Database Advanced Search (HDAS) was used to identify relevant studies. Two authors independently reviewed each study. Statistical analyses were performed using random effects models and results expressed as HR or relative risk (RR) with 95% confidence intervals. Subgroup analyses were performed in kidneys from deceased donors (DD) and living donors (LD). Results: A total of 35 studies (257,429 participants) were identified. Both deceased and living donor right kidneys were at increased risk of delayed graft function (DGF; RR = 1.12[1.06-1.18] and RR = 1.33[1.21-1.46] respectively; both p <.0001). In absolute terms, for each 100 kidney pairs of DD kidneys transplanted there are 2.72 (1.67-3.78, p <.00001) excess episodes of DGF in right kidneys. Graft thromboses and graft loss due to technical failure was also significantly more likely in right kidneys, in both DD and LD settings. There was no evidence that laterality alters long term graft survival in LD or DD. Conclusion: Right kidneys have inferior early outcomes, with higher rates of DGF, technical failure and graft thrombosis. However, these differences are small in absolute terms, and long-term graft survival is equivalent.

Publication metadata

Author(s): Carolan C, Tingle SJ, Thompson ER, Sen G, Wilson CH

Publication type: Review

Publication status: Published

Journal: Clinical Transplantation

Year: 2021

Volume: 35

Issue: 11

Print publication date: 01/11/2021

Online publication date: 08/09/2021

Acceptance date: 02/09/2021

ISSN (print): 0902-0063

ISSN (electronic): 1399-0012

Publisher: John Wiley and Sons Inc


DOI: 10.1111/ctr.14475