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The Effect of Donor-Recipient Relationship on the Immunologic Outcome in Living Kidney Transplantation.

D. Khadzhynov, F. Halleck, L. Lehner, M. Duerr, J. Waiser, K. Budde, O. Staeck.

Nephrology, Charite Campus Mitte, Berlin, Germany.

Meeting: 2016 American Transplant Congress

Abstract number: A136

Keywords: Graft survival, Microchimerism, Rejection, Sensitization

Session Information

Date: Saturday, June 11, 2016

Session Name: Poster Session A: Kidney Donor Outcomes

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Halls C&D

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Background. Presensitization and degree of HLA-matching influences immunologic outcome and kidney graft survival. Thus the donor-recipient relationship may influence incidence of immunologic events and outcome in living related kidney transplantation (KTx). The aim of the study was to analyze the long-term immunologic outcomes of living KTx depending on the donor-recipient relationship.

Materials and methods. This retrospective single center long-term observational study included kidney transplant recipients (KTR) between 2000 and 2014. KTR from living donors (178 pts) were categorized according to donor-recipient relationship: 65 KTx between siblings, 39 father-to-child (FtC) and 74 mother-to-child (MtC) donations. DSA analysis and allograft biopsies were performed for clinically suspected rejections. Data analysis included patient and graft survival, biopsy proven rejection episodes (T-cell mediated (TCMR) or antibody mediated (ABMR)) and development of de novo DSA. Outcome data were assessed over a period of maximal 14 years.

Results. There were no significant difference between the groups (siblings, FtC, MtC) with regards to HLA-mismatch, prior kidney transplantation, time on dialysis and cold ischemia time. Donor-recipient relationship had no significant influence on graft survival (Fig 1A). Among KTR with related donors FtC- and MtC-pares showed comparable incidences of TCMR, both significantly exceeding the rate in sibling-to-sibling pares (Fig 2B). The multivariant cox regression analysis adjusted for recipient age, donor age and HLA (A, B, DR)-mismatch identified both MtC and FtC donation as important independent risk factors for TCMR (HR 8.13, p<0.001 and HR 8.09, p=0.001, respectively). There was no significant difference between the groups in terms of ABMR (Fig. 1C) and development of de novo DSA (Fig. 1D) .

Conclusion. Our results point out parent-to-child kidney donation as an independent risk factor for TCMR.

CITATION INFORMATION: Khadzhynov D, Halleck F, Lehner L, Duerr M, Waiser J, Budde K, Staeck O. The Effect of Donor-Recipient Relationship on the Immunologic Outcome in Living Kidney Transplantation. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Khadzhynov D, Halleck F, Lehner L, Duerr M, Waiser J, Budde K, Staeck O. The Effect of Donor-Recipient Relationship on the Immunologic Outcome in Living Kidney Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/the-effect-of-donor-recipient-relationship-on-the-immunologic-outcome-in-living-kidney-transplantation/. Accessed February 28, 2021.

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