Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Living donor kidney transplantation (LDKT) has significant benefits over deceased donor kidney transplantation (DDKT) in terms of improved survival and timely access to transplant. There is scope to increase the living donor pool in the UK, but there are limited data regarding the factors that enable patients to receive an LDKT. We investigated this in the UK Access to Transplantation and Transplant Outcome Measures (ATTOM) study.
1777 incident kidney transplant recipients 18-75 yrs were recruited between 2011-2013 from all UK renal units. 1077 received DDKT and 700 LDKT. Baseline data were collected at time of transplant. A step-wise multivariate logistic regression model was built to analyse factors predicting the likelihood of LDKT versus DDKT. 1-year graft and patient survival were calculated using the Kaplan-Meier method.
58.6% LDKTs were from blood-related living donors, of which 47.1% were parent/child, 43.4% sibling and 9.6% other relatives. A significantly higher proportion of LDKTs were pre-emptive compared with DDKTs (38.5% vs 12.6%, p<0.0001).
Factors significantly reducing the likelihood of LDKT included increasing age (per year, odds ratio [OR] 0.96 p<0.0001), Asian ethnicity (OR 0.51 p=0.0003), Black ethnicity (OR 0.61 p=0.04) and being divorced/separated/widowed (OR 0.58 p=0.002). Factors increasing the likelihood of LDKT included female gender (OR 1.25 p=0.04), basic education (OR 1.31 p=0.04), higher education (OR 1.46 p=0.01), car ownership (OR 2.21 p<0.0001) and house ownership (OR 1.35 p=0.02).
1 year graft survival was significantly higher for LDKT (98.1% [95% CI 96.8-98.9]) than DDKT (95.7% [95% CI 94.3-96.7]) p=0.005. 1 year patient survival post LDKT was 99.0% (95% CI 97.7-99.5) and post DDKT was 97.6% (95% CI 96.4-98.4) p=0.0548.
LDKT offers better 1 year graft and patient survival than DDKT. Amongst patients suitable for transplantation, those who are older, male, divorced, from ethnic minorities, have a lower level of education and greater social deprivation are less likely to receive LDKT in the UK.
CITATION INFORMATION: Wu D, Robb M, Watson C, Ravanan R, Forsythe J, Metcalfe W, Dudley C, Bradley C, Draper H, Bradley A, Oniscu G. Young, Caucasian, Better Educated and Less Socially Deprived Patients Are More Likely to Be Transplanted with a Living Donor Kidney in the UK. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Wu D, Robb M, Watson C, Ravanan R, Forsythe J, Metcalfe W, Dudley C, Bradley C, Draper H, Bradley A, Oniscu G. Young, Caucasian, Better Educated and Less Socially Deprived Patients Are More Likely to Be Transplanted with a Living Donor Kidney in the UK. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/young-caucasian-better-educated-and-less-socially-deprived-patients-are-more-likely-to-be-transplanted-with-a-living-donor-kidney-in-the-uk/. Accessed November 25, 2020.
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