The Impact of Pre-Donation eGFR on Recipient Outcomes, as a Function of Donor Age.
1Medicine, UBC, Vancouver, BC, Canada
2BC Renal Agency, Vancouver, BC, Canada.
Meeting: 2016 American Transplant Congress
Abstract number: C140
Keywords: Donation, Graft function
Session Information
Session Name: Poster Session C: Kidney Donor Evaluation and Donor Nephrectomy
Session Type: Poster Session
Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Transplantation from older living kidney donors is increasing. Studies have shown that living donor age only modestly impacts recipient outcomes, but the kidney function of donors has not been accounted for in these studies. We examined the impact of pre-donation eGFR on post-transplant outcomes, as a function of donor age.
Methods: Using SRTR data, we identified 67,292 living donors between 1999-2009, with followup until 2011. The association of pre-donation eGFR (MDRD eGFR <80,80-89,90-99,>100 ml/min) with recipient eGFR at 1 year post transplant and all cause graft loss was determined using multivariate linear and Cox models, as a function of living donor age.
Results: Median pre-donation eGFR was lowest in donors >60yrs (78.5 ml/min) vs donors aged 18-39 (98.1) and 40-59 yrs (84.0), p<0.001. Pre-donation eGFR in all donor age groups was directly associated with recipient eGFR at 1 yr. This effect was most pronounced in older donors, with an additive impact of donor age and pre-donation eGFR on recipient eGFR(Table 1). Pre-donation eGFR <80ml/min was ONLY associated with an increased risk of graft loss when the donor was aged > 60 yrs (Table 2).
| Table 1: Adjusted recipient eGFR at 1 year post transplant, by donor age and pre-donation eGFR | |||
| Pre-donation eGFR |
18-39 yrs adj eGFR (95% CI) |
40-59 yrs |
>60 yrs |
| <80ml/min (n=18,421) | -7.42 (-8.20, -6.66) | -14.44 (-15.07, -13.80) | -21.84 (-24.16, -20.51) |
| 80-89.9 (n=13,811) | -5.85 (-6.61, -5.08) | -11.48 (-12.19, -10.88) | -18.34 (-20.64, -16.04) |
| 90-99.9 (n=13,878) | -2.91 (-3.69, -2.12) | -10.32 (-11.02, -9.62) | -16.39 (-18.76, -14.03) |
| >100 (n= | 0.00 (Reference) | -6.94 (-7.71, -6.17) | -13.06 (-15.39, -10.70) |
| Each value represents the adjusted eGFR relative to the reference group (18-39 yrs with eGFR >100ml/min) | |||
| Table 2: HR for all cause graft loss by pre-donation eGFR and donor age | |||
| Pre-donation eGFR |
18-39 yrs HR (95%CI) |
40-59yrs
|
>60 yrs
|
| <80 ml/min | 1.06 (0.97, 1.15) | 1.03 (0.95, 1.12) | 1.67 (1.26,2.22) |
| 80-89.9 | 1.09 (1.00, 1.18) | 0.96 (0.88, 1.06) | 1.64 (1.18,2.28) |
| 90-99.9 | 0.99 (0.92, 1.08) | 0.99 (0.90,1.08) | 1.37 (0.97,1.95) |
| >100 | 1.00 | 1.00 | 1.00 |
Lower pre-donation eGFR in living donors is associated with inferior recipient outcomes, but this is most dominant with older donors. These findings suggest that the cumulative impact of donor age AND pre-donation eGFR on recipient outcomes should be considered when selecting living donors.
CITATION INFORMATION: Gill J, Dong J, Djurdjev O, Lesage J, Rose C, Gill J. The Impact of Pre-Donation eGFR on Recipient Outcomes, as a Function of Donor Age. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Gill J, Dong J, Djurdjev O, Lesage J, Rose C, Gill J. The Impact of Pre-Donation eGFR on Recipient Outcomes, as a Function of Donor Age. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-impact-of-pre-donation-egfr-on-recipient-outcomes-as-a-function-of-donor-age/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress