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.
- kidney transplantation
- living donation
- donor source
- patient survival
- graft survival