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).
|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.
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 20, 2019.
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