The association of living donor source with patient and graft survival among kidney transplant recipients in the ERA-EDTA Registry

Samar Abd ElHafeez, Marlies Noordzij, Anneke Kramer (Lead / Corresponding author), Samira Bell, Emilie Savoye, José María Abad-Díez, Torbjörn Lundgren, Anna Varberg Reisæter, Julia Kerschbaum, Carmen Santiuste de Pablos, Fernanda Ortiz, Frederic Collart, Runolfur Palsson, Mustafa Arici, James G. Heaf, Ziad A. Massy, Kitty J. Jager

Research output: Contribution to journalArticle

Abstract

Aim: To compare patient and graft survival of kidney transplant recipients who received a kidney from a living-related donor (LRD) or living-unrelated donor (LUD).

Methods: Adult patients in the ERA-EDTA Registry who received their first kidney transplant in 1998-2017 were included. Ten-year patient and graft survival were compared between LRD and LUD transplants using Cox regression analysis.

Results: In total, 14,370 patients received a kidney from a living donor. Of those, 9,212 (64.1%) grafts were from a LRD, 5,063 (35.2%) from a LUD and for 95 (0.7%) the donor type was unknown. Unadjusted five-year risks of death and graft failure (including death as event) were lower for LRD transplants (4.2%, 95% confidence interval [CI]: 3.7-4.6 and 10.8%, 95%CI: 10.1-11.5, respectively) than for LUD grafts (6.5%, 95%CI: 5.7-7.4 and 12.2%, 95%CI: 11.2-13.3, respectively). However, after adjusting for potential confounders, associations disappeared with hazard ratios of 0.99 (95%CI: 0.87-1.13) for patient survival and 1.03 (95%CI: 0.94-1.14) for graft survival. Unadjusted risk of death-censored graft failure was similar, but after adjustment it was higher for LUD transplants (1.19; 95%CI: 1.04-1.35).

Conclusion: Patient and graft survival of LRD and LUD kidney transplant recipients was similar, whereas death-censored graft failure was higher in LUD. These findings confirm the importance of both living kidney donor types.
Original languageEnglish
JournalTransplant International
Early online date6 Oct 2020
DOIs
Publication statusE-pub ahead of print - 6 Oct 2020

Keywords

  • kidney transplantation
  • living donation
  • donor source
  • patient survival
  • graft survival

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    Abd ElHafeez, S., Noordzij, M., Kramer, A., Bell, S., Savoye, E., Abad-Díez, J. M., Lundgren, T., Reisæter, A. V., Kerschbaum, J., Santiuste de Pablos, C., Ortiz, F., Collart, F., Palsson, R., Arici, M., Heaf, J. G., Massy, Z. A., & Jager, K. J. (2020). The association of living donor source with patient and graft survival among kidney transplant recipients in the ERA-EDTA Registry. Transplant International. https://doi.org/10.1111/tri.13759