Kidney Transplantation from Marginal Donors: An Increased Risk of Urinary Complication. Study from 10279 Patients

B. Mesnard¹, M. Leroy², J. Hunter³, D. Kervella¹, M. Timsit⁴, L. Badet⁵, P. Glemain¹, E. Morelon⁵, F. Buron⁵, M. Le Quintrec-Donnette⁶, V. Pernin⁶, M. Ladriere⁷, S. Girerd⁷, C. Legendre⁴, A. Sicard⁸, L. Albano⁸, S. De Vergie¹, C. Kerleau¹, T. Prudhomme⁹, J. Rigaud¹, D. Cantarovich¹, G. Blanchot¹, G. Karam¹, M. Giral¹, S. Ville¹, J. Branchereau¹

¹Department of Urology, Chu Nantes, Nantes Université, ITUN, Nantes, France, Nantes, France, ²Department of Urology, Chu Nantes, Nantes Université, France, Nantes, France, ³Department of Urology, Nuffield Department of Surgical Science ,Oxford, Oxford, United Kingdom, ⁴Service de transplantation rénale, Hôpital Necker AP-HP, Paris, France, ⁵Service de transplantation, néphrologie et immunologie clinique, Hôpital Edouard Herriot, Hospices de Lyon, Lyon, France, ⁶Service de néphrologie-soins intensifs-dialyse et transplantation, Hôpital Lapeyronie, Montpellier, France, ⁷Service de transplantation rénale, CHU Brabois, Nancy, France, ⁸Service de néphrologie, Hôpital Pasteur, Nice, France, ⁹Service urologie, andrologie et transplantation rénale, Hôpital Rangeuil, CHU de Toulouse, Toulouse, France

Meeting: 2021 American Transplant Congress

Abstract number: 989

Keywords: Donors, marginal, Kidney transplantation, Surgical complications

Topic: Clinical Science » Kidney » Kidney Technical

Session Information

Session Name: Kidney Technical

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Due to the increasing need of kidneys suitable for transplantation, we have expanded the donor population to include marginal donors (Extended criteria donor, controlled and uncontrolled donation after circulatory death). The implication of such a strategy in terms of urinary complications has only been marginally analysed. The objective of this work is to evaluate the impact of marginal donors on urological complications.

*Methods: Between January 1, 2002 and January 1, 2018, 10279 kidney transplants in adult recipients were recorded within the DIVAT network (Computerized and VAlidated Data in Transplantation). Data were extracted in relation to 44 pre-and-post-operative variables, ECD status was included, according to United Network for Organ Sharing definition (UNOS). The main analysis focused on associations between the donor ECD/SCD status, donor type (DBD, uncontrolled/controlledDCD) and urinary complications at 1 year.

*Results: Overall urological complication rate was 16.26%. The donor’s ECD status was significantly associated with an increased risk of urinary complications at 1 year in Multivariate analysis (OR: 1.50 (1.31-1.71), p <0.001). There is no association between donor type and urinary complication. The placement of an endo-ureteric stent was beneficial in preventing urinary complications in all donors and particularly in ECD donors. The presence of an urinary complication in the first year seems to be associated with the occurrence of transplant failure after one year.

*Conclusions: The donor’s ECD status is associated with stenosis and ureteric fistulas at 1 year. Recipients of grafts from ECD donors should probably be considered for closer urological monitoring and systematic preventive measures. Urological skill and urologists involvement in kidney transplantation could contribute to reduce the associated risk of these complications.

To cite this abstract in AMA style:

Mesnard B, Leroy M, Hunter J, Kervella D, Timsit M, Badet L, Glemain P, Morelon E, Buron F, Quintrec-Donnette MLe, Pernin V, Ladriere M, Girerd S, Legendre C, Sicard A, Albano L, Vergie SDe, Kerleau C, Prudhomme T, Rigaud J, Cantarovich D, Blanchot G, Karam G, Giral M, Ville S, Branchereau J. Kidney Transplantation from Marginal Donors: An Increased Risk of Urinary Complication. Study from 10279 Patients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-transplantation-from-marginal-donors-an-increased-risk-of-urinary-complication-study-from-10279-patients/. Accessed May 16, 2025.

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