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Live Donor Kidney Transplantation: Recipient Outcomes When the Donor Developed ESRD

A. Muzaale, A. Massie, D. Segev.

Johns Hopkins University, Baltimore, MD.

Meeting: 2015 American Transplant Congress

Abstract number: B169

Keywords: Graft failure

Session Information

Session Name: Poster Session B: Living Donor Issues 1

Session Type: Poster Session

Date: Sunday, May 3, 2015

Session Time: 5:30pm-6:30pm

 Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Recipient outcomes when the donor developed ESRD remain uncharacterized.

Method: A cohort of 99 LDKT recipients between 04/1994-11/2011, whose donors subsequently developed ESRD, was compared with a matched cohort of 404 LDKT recipients, whose donors did not develop ESRD. Matching was based on donor age, race, relationship-to-recipient, HLA mismatch, PRA, recipient age, race, BMI, cause of ESRD, sex, time-on-dialysis, and year of transplant. Maximum follow-up was 15-years; median follow-up was 7.6-years (interquartile range [IQR], 3.9-11.5 years).

Results: Recipient outcomes (69% graft failure and 42% mortality at 15 years) were worse among recipients whose donor developed ESRD compared with recipients whose donor did not develop ESRD (47% graft failure and 26% mortality at 15 years; adjusted HR=1.7, p<0.001 for graft failure; adjusted HR=1.9, p=0.003 for mortality)(Table 1 & Figure 1). This effect varied substantially by donor race/ethnicity, predonation BMI, and eGFR (Figure 2).

Recipient Risk of Graft Failure, Stratified by Donor Outcome
Subgroups 15-year Recipient Graft Failure (%) Adjusted HR (95%CI) P
Donor Developed ESRD 69 1.74 <.001
Donor Did Not Develop ESRD 47 Ref  
       
Donor White, Developed ESRD 76 2.42 <.001
Donor White, Did Not Develop ESRD 41 Ref  
Donor Black, Developed ESRD 55 1.12 .7
Donor Black, Did Not Develop ESRD 57 Ref  
Donor Hispanic, Developed ESRD 69 1.35 .5
Donor Hispanic, Developed ESRD 45 Ref  
       
Donor BMI<30, Developed ESRD 48 1.02 .9
Donor BMI<30, Did Not Develop ESRD 47 Ref  
Donor BMI>=30, Developed ESRD 71 2.03 <.001
Donor BMI>=30, Did Not Develop ESRD 45 Ref  
       
Donor eGFR<90, Developed ESRD 75 1.61 .3
Donor eGFR<90, Did Not Develop ESRD 34 Ref  
Donor eGFR>=90, Developed ESRD 68 1.8 <.001
Donor eGFR>=90, Did Not Develop ESRD 47 Ref  

Conclusions: Recipient outcomes were worse for recipients whose donor developed ESRD, but only when the donor was white, obese, with high predonation eGFR.

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To cite this abstract in AMA style:

Muzaale A, Massie A, Segev D. Live Donor Kidney Transplantation: Recipient Outcomes When the Donor Developed ESRD [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/live-donor-kidney-transplantation-recipient-outcomes-when-the-donor-developed-esrd/. Accessed May 9, 2025.

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