Background. In recent years, even after the new road safety legislation adopted by Western governments that have helped reduce the number of deaths caused by brain injuries, in many Transplant Centers has gradually increased the use of living donors (LD) for patients in waiting list for kidney transplantation (KT). Methods. In the period January 1983-June 2008, in our Center were performed 117 KT from LD. Of these, 97 were from living related donors (LRD) and 20 from living unrelated donors (LUD). The latter were related to the recipients only by legal relationship (spouses). For the D/R degree of compatibility was considered the AB0 blood group, HLA-A,B,DR typization, and cross-matching. At the time of KT, all the recipients were negative for detection of antibodies against a panel of cytotoxic lymphocytes. Results. By comparing continuous variables between LRD and LUD groups, a significant difference was found for recipient age (LRD: 27.7±14 years; LUD: 50.6±6.5 years; p<0.001) and number of HLA mismatches (LRD: 2.2±1; LUD: 4.2±1.2; p<0.001). No significant difference was observed for patient survival at 5 and 10 years after kidney transplantation between LRD and LUD group (96% vs. 92%, p = 0.542; 93% vs. 91%, p = 0.938), as well as for graft survival at the same time points (77% vs. 92%, p = 0.276; 58% vs. 81%, p = 0.177). Belonging to LUD group was not significant in univariate Cox regression model for patient survival (β= 0.138; p=0.900) or graft survival (β= -1.01; p=0.170). In multivariate Cox models in which were included as independent variables also patient age, sex, and number of HLA mismatches, belonging to LUD group was not significant for patient survival (β= -0.379, p value=0.780), whereas a statistical significance with negative regression coefficient occurred for graft survival (β= -1.645, p value=0.043). Conclusions. The analysis of our series suggests that the KT from LUD can provide an alternative to LRD in order to increase the donor pool and reduce the patients on the waiting list.
Living-related and unrelated donors in kidney transplantation: a single center experience.
SANTORI, GREGORIO;VALENTE, UMBERTO
2009-01-01
Abstract
Background. In recent years, even after the new road safety legislation adopted by Western governments that have helped reduce the number of deaths caused by brain injuries, in many Transplant Centers has gradually increased the use of living donors (LD) for patients in waiting list for kidney transplantation (KT). Methods. In the period January 1983-June 2008, in our Center were performed 117 KT from LD. Of these, 97 were from living related donors (LRD) and 20 from living unrelated donors (LUD). The latter were related to the recipients only by legal relationship (spouses). For the D/R degree of compatibility was considered the AB0 blood group, HLA-A,B,DR typization, and cross-matching. At the time of KT, all the recipients were negative for detection of antibodies against a panel of cytotoxic lymphocytes. Results. By comparing continuous variables between LRD and LUD groups, a significant difference was found for recipient age (LRD: 27.7±14 years; LUD: 50.6±6.5 years; p<0.001) and number of HLA mismatches (LRD: 2.2±1; LUD: 4.2±1.2; p<0.001). No significant difference was observed for patient survival at 5 and 10 years after kidney transplantation between LRD and LUD group (96% vs. 92%, p = 0.542; 93% vs. 91%, p = 0.938), as well as for graft survival at the same time points (77% vs. 92%, p = 0.276; 58% vs. 81%, p = 0.177). Belonging to LUD group was not significant in univariate Cox regression model for patient survival (β= 0.138; p=0.900) or graft survival (β= -1.01; p=0.170). In multivariate Cox models in which were included as independent variables also patient age, sex, and number of HLA mismatches, belonging to LUD group was not significant for patient survival (β= -0.379, p value=0.780), whereas a statistical significance with negative regression coefficient occurred for graft survival (β= -1.645, p value=0.043). Conclusions. The analysis of our series suggests that the KT from LUD can provide an alternative to LRD in order to increase the donor pool and reduce the patients on the waiting list.
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