Changes in residual kidney Pulsatility Index following living donor nephrectomy

Objective: Nephrectomy in kidney transplant donors provokes a compensatory hyperfiltration process of the residual kidney, characterized by changes in renal vascular hemodynamics. This research aimed to determine the short-term difference in the pulsatility index (PI) of kidney transplant donors’ residual kidney before and after nephrectomy. Methods: This is a prospective historical study using secondary data from kidney transplant living donors who have undergone nephrectomy at a tertiary referral hospital in Jakarta, Indonesia, from March 2019 to January 2020. PI of renal, segmental, interlobar, and arcuate arteries of the residual kidneys were measured in the preoperative and day-1, day-7, day-30 postoperative period. The pre- and postoperative PI values were statistically analyzed to examine differences between the groups. Results: PI of 40 residual kidneys were obtained. There were no significant mean PI changes in the arteries except for the middle interlobar artery (p = 0.049), which showed no significant difference after post hoc analysis. Conclusions: There is no significant short-term difference in PI of the residual kidney before and after kidney transplant donor nephrectomy. Advances in knowledge: Short-term postoperative PI of the residual kidney arteries may not be suitable as a predictor for chronic kidney disease in kidney transplant donors. Other quantitative Doppler ultrasound parameters must be considered.