Donor kidney adapts to body dimensions of recipient: no influence of donor gender on renal function after transplantation.

Female kidneys and kidneys from small donors have been suggested to perform worse after kidney transplantation. Here, we evaluate the impact of gender and body dimensions on posttransplantation GFR in living donor transplantation. Two hundred and ninety-three donor-recipient pairs, who were transplanted at our center were evaluated. All pairs had detailed renal function measurement ((125) I-iothalamate and (131) I-hippuran) 4 months predonation in the donor and 2.5 months posttransplantation in donor and recipient. For 88 pairs, 5 years of recipient follow-up was available. Delta GFR was calculated as (recipient GFR-donor single kidney GFR). Recipients of both male and female kidneys had similar renal function at early and long term after transplantation. Male recipients had higher ERPF, ΔGFR and ΔERPF at both time points. Kidneys of donors smaller than their recipient had higher ΔGFR and ΔERPF than kidneys of larger donors at both time points (p < 0.05). In multivariate analysis, ΔGFR was predicted by donor/recipient BSA-ratio together with transplantation related factors (R(2) 0.19), irrespective of donor and recipient gender. In conclusion, in living donor transplantation, female kidneys perform as well as male donor kidneys. Kidneys adapt to the recipient's body size and demands, independent of gender, without detrimental effects in renal function and outcome up to mid-long term.

Haemosiderosis in the placenta does not appear to be related to chronic placental separation or adverse neonatal outcome.

AIMS: To ascertain the incidence and to review the obstetric and neonatal correlates of placental haemosiderosis. Secondly, to determine if placental haemosiderosis is due to blood contamination during placental handling. METHODS: One hundred consecutive singleton placentas with and 113 consecutive singleton placentas from uncomplicated pregnancies without an indication for pathological examination were stained for iron to detect haemosiderosis in the membranes, chorionic plate and/or basal plate. The obstetric and neonatal data were analysed. In the second part, maternal retroplacental blood was placed on the chorionic plates of 15 placentas for 1, 3, 4 and 5 days prior to sampling and examination for iron deposition. RESULTS: Haemosiderosis was observed in 110 of 213 (51.6%) placentas. Early decelerations during fetal heart rate monitoring (p = 0.0498) and, negatively, maternal thrombophilia (p = 0.0496) were related to haemosiderosis in the placenta. Preterm delivery, chronic separation of the placenta or procedures performed during pregnancy or delivery were not significantly related to haemosiderosis. Different patterns of iron staining were observed but these were not correlated with any maternal or neonatal factors. In the experimental study, haemosiderin was not found in sections taken at various time intervals from both blood contaminated and blood contamination-free parts of the placentas. CONCLUSIONS: Haemosiderosis in the placenta is not an artefact of placental handling. Haemosiderosis is seen considerably more frequently than previously reported and may be physiological. Haemosiderosis is not a useful indicator for chronic placental abruption and adverse neonatal outcome is not significantly correlated with placental haemosiderosis.