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Author Topic: Donor-Recipient Relationship and Risk of ESKD in Live Kidney Donors by Race  (Read 979 times)

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Offline Clark

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https://www.ajkd.org/article/S0272-6386(19)31013-3/fulltext
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[/size]Donor-Recipient Relationship and Risk of ESKD in Live Kidney Donors of Varied Racial Groups, Abimereki D. Muzaale, et al., AJKD,  AJKD, Nov. 12, 2019, https://doi.org/10.1053/j.ajkd.2019.08.020
[/size]Abstract
[/size]
[/size]Rationale & Objective
[/size]Risk factors for kidney failure are the basis of live kidney donor candidate evaluation. We quantified risk for end-stage kidney disease (ESKD) by the biological relationship of the donor to the recipient, a risk factor that is not addressed by current clinical practice guidelines.[/size]Study Design
[/size]Retrospective cohort study.[/size]Setting & Participants
[/size]A cohort of 143,750 US kidney donors between 1987 and 2017.[/size]Exposure
[/size]Biological relationship of donor and recipient.[/size]Outcome
[/size]ESKD. Donors’ records were linked to national dialysis and transplantation registries to ascertain development of the outcome.[/size]Analytic Approach
[/size]Donors were observed over a median of 12 (interquartile range, 6-18; maximum, 30) years. Survival analysis methods that account for the competing risk for death were used.[/size]Results
[/size]Risk for ESKD varied by orders of magnitude across donor-recipient relationship categories. For Asian donors, risks compared with unrelated donors were 259.4-fold greater for identical twins (95% CI, 19.5-3445.6), 4.7-fold greater for full siblings (95% CI, 0.5-41.0), 3.5-fold greater for offspring (95% CI, 0.6-39.5), 1.0 for parents, and 1.0 for half-sibling or other biological relatives. For black donors, risks were 22.5-fold greater for identical twin donors (95% CI, 4.7-107.0), 4.1-fold for full siblings (95% CI, 2.1-7.8), 2.7-fold for offspring (95% CI, 1.4-5.4), 3.1-fold for parents (95% CI, 1.4-6.8), and 1.3-fold for half-sibling or other biological relatives (95% CI, 0.5-3.3). For white donors, risks were 3.5-fold greater for identical twin donors (95% CI, 0.5-25.3), 2.0-fold for full siblings (95% CI, 1.4-2.8), 1.4-fold for offspring (95% CI, 0.9-2.3), 2.9-fold for parents (95% CI, 2.0-4.1), and 0.8-fold for half-sibling or other biological relatives (95% CI, 0.3-1.6).[/size]Limitations
[/size]Insufficient sample size in some race and relationship groups. Absence of data for family history of kidney disease for donors biologically unrelated to their recipients.[/size]Conclusions
[/size]Marked differences in risk for ESKD across types of donor-recipient relationship were observed for Asian, black, and white donors. These findings warrant further validation with more robust data to better inform clinical practice guidelines.
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Unrelated directed kidney donor in 2003, 500+ time blood & platelet donor and counting!
Rep to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, & Ad Hoc Public Solicitation of Organ Donors Committees 2005-2011

 

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