*Purpose: Chronic kidney-donor shortage is major concern in Japan where more than 90% of recipients received kidneys from living donor as kidney transplantation from deceased donors occurs less. Therefore, living kidney transplantation from marginal donor (MD) is an important solution for such a problem. We evaluated the renal function and its chronological change in MD post donation to validate the adequacy of marginal donor criteria.

*Methods: Enrolled patients were 101 donors who donated their kidney at our hospital from 2014 to 2016. MD was defined as those with 70 years older, low GFR (total GFR: 70-80ml/min/1.73m²), high body mass index (BMI: 25kg/m²<), hypertension and diabetes with hemoglobin A1c >6.2%. Among 101, 25 donors (24.7%) met with marginal donor criteria. (MD group) Control group consisted of 76 patients who met standard criteria donor (SD group). The renal function after kidney donation was compared between the two groups.

*Results: MD group composed of 8 elderly patients, 9 patients with low GFR, 2 patients with high BMI, 12 patients with hypertension and 2 with diabetes mellitus (including duplicate cases). There was no difference in age at donation and sex between the two groups. The median eGFR (ml /min/1.73m²) at 1 and 3 years after kidney donation was 45.0 and 44.3 in the MD group and 51.2 and 52.9 in the SD group, which were significantly lower in the MD group. (Fig.1) On the other hand, rate of chronological change in eGFR (%) from 1 to 3 years post kidney donation was 105.7 in the MD group and 105.8 in the SD group, which indicating no difference between the two groups. (Fig.2) No cases leading to end-stage renal disease were found in either group.

*Conclusions: MD was inferior to SD in residual renal function, but did not show deterioration of renal function over time after kidney.Although indications for marginal criteria donor are valid in the short term, longer follow-up is required.

« Back to 2022 American Transplant Congress