Date: Saturday, April 29, 2017
Session Name: Poster Session A: Living Donor Kidney Transplant I
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
As the shortage of suitable deceased and living kidney donors (LD) persists, medically complex LD, including those with hypertension (HTN), are being considered for donation with unclear outcomes for both the LD and recipients (R) of those organs. Our center accepts HLD with well controlled HTN after careful screening, dietary counseling, 24 hour BP monitoring, and two 24 hr urine creatinine clearance (crcl) and protein (prot) measurements. We present the renal outcomes for HLD for both the LD and R of those kidneys.
Methods: Between 7/2011 and 11/2016 over 400 LD Tx were performed. We identified 23 HLD and age, sex and race matched them 1:1 with non-hypertensive donors (nHLD). HLD age 53.6+7.5 yrs (38-67), 11 F/12 M, 23 C/0 AA. HLD were heavier 87+14 vs 80+18 kg (NS). Predonation (pre-D) SBP was no different in HLD vs nHLD, 122+11 vs 122+10 mm Hg as was crcl 125+24 vs 124+35 cc/min and prot 111+47 vs 94+25 mg/d. LD pre-D renal function and BP were compared to 6, 12, 24 mos post-donation (post-D). R renal function was compared at 1 wk, 6 and 12 mos to assess effect of BP on graft function.
Results: Post-D renal function was no different in HLD vs nHLD. Systolic BP was significantly higher in HLD at 12 mos but was not different between groups or compared to pre-D BP at 24 mos.
|Donor||cr 6m||cr 12m||cr 24 m||BP 6m||BP 12m||BP 24 m|
|HLD||1.26+0.3||1.20+0.3||1.26+0.2||129+13||135+10 * p<0.05||131+13|
R of HLD had higher creat at 1 wk and 6 mos (p=NS) but similar at 12 mos despite significantly higher CsA levels, 691+262 vs 488+212 ng/ml (p<0.05)
|Recipient Kidney||Cr 1 wk||Cr 6 mos||Cr 12 mos|
When age was considered by tertiles, R of older HLD tended to have higher creat at 1 wk and 6 mos (p=0.1) but not 12 mos compared to nHLD, 2.1+0.7, 2.3+0.9, 2.1+0.5 vs 1.7+0.7, 1.8+0.5, 1.93+0.4 mg/dl. There was no difference in function for R of younger donors.
Conclusion: Carefully screened, well controlled, Caucasian HLD have similar renal function and BP 2 years post-donation compared to nHLD. R of HLD tended to have higher creat early post-tx but no different at 1 yr. Longer follow-up of both HLD and R function is warranted.
CITATION INFORMATION: Pesavento T, Diez A, Pelletier R, Nori U, VonVisger J. Renal Function Outcomes of Hypertensive Living Kidney Donors (HLD) and Recipients of HLD Kidneys: Results of a Case-Control Study. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Pesavento T, Diez A, Pelletier R, Nori U, VonVisger J. Renal Function Outcomes of Hypertensive Living Kidney Donors (HLD) and Recipients of HLD Kidneys: Results of a Case-Control Study. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/renal-function-outcomes-of-hypertensive-living-kidney-donors-hld-and-recipients-of-hld-kidneys-results-of-a-case-control-study/. Accessed September 16, 2019.
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