Donor Kidney Function and Donor Age on Poor Outcome of Living Unrelated vs Relat

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http://onlinelibrary.wiley.com/doi/10.1111/ctr.12388/abstract

Impact of Donor Kidney Function and Donor Age on Poor Outcome of Living Unrelated Kidney Transplantation in comparison with Living Related Kidney Transplantation
Kyung Sun Park, Jung-ho Shin, Hye Ryoun Jang, Jung Eun Lee, Woo Seong Huh, Yoon Goo Kim, Ha Young Oh andDae Joong Kim*
DOI: 10.1111/ctr.12388
Clinical Transplantation

Abstract
Living-unrelated donors (LURD) have been widely used for kidney transplantation (KT). We retrospectively reviewed 779 patients who underwent living-donor KT from 2000 to 2012, to compare outcomes of 264 KT from LURD and 515 from living-related donors (LRD), and to identify risk factors for living KT. Median follow-up was 67 months. Mean donor age, total HLA mismatches and HLA-DR mismatches were higher, and mean estimated glomerular filtration rate (eGFR) was lower in LURD. Acute rejection (AR)-free survival (P=0.018) and graft survival (P=0.025) were lower for LURD than LRD whereas patient survival rate was comparable. Cox-regression analysis showed HLA-DR mismatches (OR 1.75 for 1 mismatch; OR 2.19 for 2 mismatches), recipient age≤42 years and donor age>50 years were significant risk factors for acute rejection. For graft survival, AR and donor eGFR (OR 1.90, P=0.035) were significant. We also identified significant impact of recipient age>50 years and diabetes for patient survival. However, KT from LURD was not significant risk factor for AR (P=0.368), graft survival (P=0.205) and patient survival (P=0.836). Our data suggest that donor eGFR and donor age are independent risk factors for clinical outcomes of living KT, which can be related with poor outcome of KT from LURD.