A case-based analysis of whether living related donors listed for transplant share ESRD causes with their recipients

Arthur J. Matas, Rebecca E. Hays, Hassan N. Ibrahim

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background and objectives Two recent studies reported increased risk of ESRD after kidney donation. In both, the majority of ESRD was seen in those donating to a relative. Confounding this observation is that, in the absence of donation, relatives of those with ESRD are at increased risk for ESRD. Understanding the pathogenesis and risk factors for postdonation ESRD is critical for both donor selection and counseling. Design, setting, participants, & measurements We hypothesized that if familial relationship was an important consideration in pathogenesis, the donor and linked recipient would share ESRD etiology. We obtained information from the Organ Procurement and Transplantation Network (OPTN) on all living kidney donors subsequently waitlisted for a kidney transplant in the United States between January 1, 1996 and November 30, 2015, to determine (1) the donor–recipient relationship and (2) whether related donor–recipient pairs had similar causes of ESRD. Results We found that a significant amount of information, potentially available at the time of listing, was not reported to the OPTN. Of 441 kidney donors listed for transplant, only 169 had information allowing determination of interval from donation to listing, and only 99 (22% of the total) had information on the donor– recipient relationship and ESRD etiology. Of the 99 donors, 87 were related to their recipient. Strikingly, of the 87, only a minority (23%) of donor–recipient pairs shared ESRD etiology. Excluding hypertension, only 8% shared etiology. Conclusions A better understanding of ESRD in donors requires complete and detailed data collection, as well as a method to capture all ESRD end points. This study highlights the absence of critical information that is urgently needed to provide a meaningful understanding of ESRD after kidney donation. We found that of living related donors listed for transplant, where both donor and recipient cause of ESRD is recorded, only a minority share ESRD etiology with their recipient.

Original languageEnglish (US)
Pages (from-to)663-668
Number of pages6
JournalClinical Journal of the American Society of Nephrology
Volume12
Issue number4
DOIs
StatePublished - 2017

Bibliographical note

Funding Information:
We greatly appreciate the help of Eric Beeson at the Organ Procurement and Transplantation Network, who provided the initial data and kindly addressed all of our follow-up questions. We thank Mary Knatterud for editorial assistance, and Hang McLaughlin and Stephanie Taylor for assistance preparing the manuscript. This workwassupportedin part by Health Resourcesand Services number 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the US Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US government.

Keywords

  • Chronic
  • Counseling
  • Donation
  • Donor selection
  • ESRD
  • Humans
  • Hypertension
  • Kidney
  • Kidney failure
  • Kidney transplantation
  • Live kidney donor
  • Living
  • Outcomes
  • Risk factors
  • Tissue and organ procurement
  • Tissue donors
  • Transplant
  • United States

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