SP 8.08 Determinants of Early Renal Functional Recovery Following Live Donor Nephrectomy: A Single-Centre Analysis
Rahma Abbas, Tunde CampbellAbstract
Introduction
Live donor nephrectomy (LDN) is widely regarded as a safe procedure; however, the immediate postoperative period represents a critical phase of renal adaptation. Identifying factors associated with early postoperative renal functional change may help refine donor counselling and perioperative management strategies.
Methods
A retrospective audit was conducted of live donors undergoing laparoscopic nephrectomy at a single tertiary transplant centre. Donors operated on between August 2024 and September 2025 with complete electronic records were included. Early renal function was assessed using the percentage decline in estimated glomerular filtration rate (eGFR) from baseline to postoperative nadir during the index admission. Statistical analysis was performed using Jamovi.
Results
Ninety-three live kidney donors were included. Mean baseline eGFR was 86.7 mL/min/1.73 m², falling to a mean postoperative nadir of 53.2 mL/min/1.73 m², representing a mean percentage decline of 39%. On multivariable linear regression, increasing age and body mass index were associated with a greater percentage decline in eGFR, while hypertension was not associated with greater early eGFR decline. Baseline eGFR demonstrated a weak negative correlation with percentage eGFR decline (r = −0.18, p = 0.075). Median length of stay was four days, consistent with the centre’s enhanced recovery after surgery (ERAS) pathway.
Conclusion
Early renal functional decline following LDN demonstrates a predictable pattern. Increasing age and body mass index may influence the magnitude of early renal decline, while hypertension was not associated with greater early decline in this cohort. These findings support current donor selection practices and may help inform donor counselling.