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Lookup NU author(s): Dr Sam Tingle,
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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.
Author(s): Carolan C, Tingle SJ, Thompson ER, Sen G, Wilson CH
Publication type: Review
Publication status: Published
Journal: Clinical Transplantation
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