Living Donor Kidney Transplant in Recipients with Glomerulonephritis: Donor Recipient Biologic Relationship and Allograft Outcomes
1Nephrology, University of Minnesota, Minneapolis, MN, 2MHealth, Minneapolis, MN
Meeting: 2022 American Transplant Congress
Abstract number: 97
Keywords: Donors, unrelated, Glomerulonephritis, Graft survival, Kidney transplantation
Topic: Clinical Science » Kidney » 39 - Kidney Living Donor: Long Term Outcomes
Session Information
Session Name: Kidney Living Donor: Long Term Outcomes
Session Type: Rapid Fire Oral Abstract
Date: Sunday, June 5, 2022
Session Time: 5:30pm-7:00pm
Presentation Time: 5:50pm-6:00pm
Location: Hynes Room 206
*Purpose: Controversies exist over the impact of donor-recipient biologic relationship on the outcomes of living donor kidney transplant in recipients with glomerulonephritis (GN). The improved degree of HLA matching among the related pair could reduce the risk of allograft rejection yet may increase the risk for GN recurrence which could affect allograft survival.
*Methods: Using SRTR , we examined the association between donor-recipient relationship and recipient and allograft survival among recipients with GN. Four GN’s were studied: membranous nephropathy, IgA, lupus nephritis, and FSGS. We identified all adult primary living donor recipients between 2000-2017 (n=19,668):related (n=10,437); unrelated (n=9,231). Kaplan-Meier curves were generated for 10 yr recipient and death censored graft survival. Multivariable Cox proportional hazard model was used to adjust for pertinent recipient and donor characteristics: age, gender, race, dialysis vintage, HLA match, crossmatch, transplant year, donor eGFR and BMI. Secondary outcomes included rejection at 12months.
*Results: There was no difference in recipient or death censored graft survival between living related and unrelated donor kidney transplants in all GN subtypes. There was an increased risk for acute rejection at 12 months post transplant among the unrelated compared to the related group in 3 GN subtypes respectively: IgA (10.1% vs 6.5%, p<0.001), FSGS (12.1% vs 10%, p-0.016), lupus nephritis (11.8% vs 9.2%; p-0.049). In the multivariable models, biological donor-recipient relationship was not associated with worse recipient or graft survival.
| GN | Recipient Survival | Death Censored Graft Survival |
| IgA | 1.03(0.8-1.4)p0.83 | 1.01(0.84-1.22)p0.9 |
| lupus | 0.89(0.7-1.2)p0.41 | 0.87(0.71-1.08)p0.2 |
| FSGS | 1.08(0.8-1.3)p0.46 | 1.08(0.9-1.3)p0.3 |
| MN | 1.06(0.75-1.5)p0.73 | 1.16(0.87-1.54)p0.31 |
HR related donor-recipient pair (reference group,unrelated pair).
*Conclusions: In this large cohort study, biologic donor-recipient relationship was associated with lower rejection rates in IgA, SLE and FSGS. Additionally, it was not associated with worse recipient or graft survival in any of the GN groups. These findings are consistent with the known benefits of living related donor kidney transplant and calls into questions a recent study suggesting adverse impact of donor recipient biologic relationship on allograft outcomes.
To cite this abstract in AMA style:
El-Rifai R, Spong R, Bregman A, Swanson K, Jackson S, Riad S. Living Donor Kidney Transplant in Recipients with Glomerulonephritis: Donor Recipient Biologic Relationship and Allograft Outcomes [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/living-donor-kidney-transplant-in-recipients-with-glomerulonephritis-donor-recipient-biologic-relationship-and-allograft-outcomes/. Accessed November 21, 2024.« Back to 2022 American Transplant Congress