Little is known if a kidney from a hypertensive donor performs equally compared to a kidney from a non-hypertensive donor. The present study examines the effect of a kidney transplant from hypertensive donors regarding blood pressure, kidney function and histologic changes in recipients.

Retrospective single center analysis of 189 (age>18, transplantation date 2008-2015) living donor kidney recipients. Recipients were followed up for one year after transplantation. Hypertension in donors was defined as being on one or more antihypertensive drugs or having a blood pressure >135/85 on ABPM. GFR was estimated using the CKD-Epi equation. Implantation biopsy data was available in 168 patients and one year protocol data was available in 161 patients. Biopsies were regarded as representative if they included four or more glomeruli. All biopsies were reviewed by the same experienced nephropathologist blinded to donor hypertension status.

One-year follow up was complete in 183 participants. Coronary heart disease, donor age and donor BMI were significantly higher in the recipients from hypertensive donors. Mean donor systolic and diastolic blood pressure was significantly higher in the group with kidneys from hypertensive donors. Recipient blood pressure did not show a significant difference between groups at time of transplant or after one year. Recipients from hypertensive donors needed significantly more anti-hypertensive medication to reach the same blood pressure levels compared to recipients from normotensive donors. At time of transplantation and after one year TRCS was significantly greater in the group with kidneys from hypertensive donors. In both groups TRCS progressed significantly from time of transplantation to one year follow up. Logistic regression showed a significant association between hypertension, donor age and histologic abnormalities at time of transplantation.

After adjusting for multiple confounders, donor hypertension was not associated with eGFR at one year. Recipient age, donor age, acute rejection, and choice of calcineurin inhibitor were independently associated with eGFR after one year of follow up.

TRCS was significantly higher in hypertensive donors at time of transplantation and after one year of follow up .

There was no difference in renal function after 1 year.

Donor hypertension was not associated with renal function in recipients after one year.

CITATION INFORMATION: Dienemann T., Schellenberg J., Amann K., Heller K., Weidemann A. Renal Function, Blood Pressure, and Histologic Changes in Living Kidney Transplant Recipients from Hypertensive Donors Am J Transplant. 2017;17 (suppl 3).

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