Kidney Transplant from Sickle Cell Donors
University of Mississippi, Jackson, MS
Meeting: 2020 American Transplant Congress
Abstract number: D-019
Keywords: Donors, marginal, Kidney transplantation, Renal function, Risk factors
Session Information
Session Name: Poster Session D: Kidney Deceased Donor Selection
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Patients with End-stage renal disease have an increased risk of death. Dialysis and kidney transplantation are the only treatments. Patients who receive kidney transplantation live longer and have a better quality of life compared to patients on dialysis. Approximately a hundred thousand patients are waiting for a kidney transplant and approx 20,000 transplants are performed every year. The gap is primarily due to a shortage of kidney donors.
Potential organ donors with sickle cell disease (SCD) are not considered for kidney donation because patients with SCD have alterations in renal hemodynamics and impaired urinary concentration ability. Patients with SCD are at increased risk for acute kidney injury, chronic kidney disease, and ESRD.
*Methods: We present outcomes of four kidney transplant recipients who received kidney transplants from two sickle cell donors.
*Results: All patients received Thymoglobulin induction, maintenance was with Prograf, Cellcept, and Prednisone. No DGF was observed.
Recipient 1: Good allograft function, experienced two major rejection episodes due to non-adherence and failed transplant at 34 months. Recipient 2: Good allograft function, lost to follow up with our transplant center at 5 yrs. Last know eGFR > 60.Recipient 3: Suboptimal renal function, biopsy at two months show no rejection, interstitial fibrosis approx 50%. However, eGFR continues to improve. Currently, at 39, three months post-transplant.Recipient 4: Good allograft function, eGFR > 60 at three months.
*Conclusions: Kidney transplantation from sickle cell donors appears to be safe with acceptable short term and long term outcomes. However, the selection of appropriate donors appears to be the key to successful transplantation. Both of our donors were young and had a good renal function and terminal creatinine prior to donation.
In the era of increasing demand and supply gap for kidney transplantation, using selective sickle cell donors may expand the donor pool and improve transplant access.
| Donor 1 | Donor 2 | |
| Age in yrs | 23 | 37 |
| Cause of death | Stroke | Stroke |
| Terminal creatinine | 0.5 | 0.96 |
| KDPI | 23 % | 53% |
| DM-2 | No | No |
| R 1 | R 2 | R 3 | R4 | |
| Age in yrs | 21 | 40 | 61 | 39 |
| Race | AA | AA | AA | AA |
| Cause of ESRD | Dysplastic kidneys | PCKD | HTN | HTN |
| DGF | No | No | No | No |
| eGFR 1 month | > 60 | > 60 | 36 | > 60 |
| e GFR 3 months | > 60 | >60 | 39 | >60 |
| BMI | 20 | 25 | 36 | 32 |
To cite this abstract in AMA style:
Vaitla P, Rivera FHCabeza, Cheungpasitporn W, Koller F, Matemavi P, Wynn J. Kidney Transplant from Sickle Cell Donors [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-transplant-from-sickle-cell-donors/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress