Donor factors influencing graft outcomes in live donor kidney transplantation

Naim Issa, Brian Stephany, Richard Fatica, Saul Nurko, Venkatesh Krishnamurthi, David A. Goldfarb, William E. Braun, Vincent W. Dennis, Peter S. Heeger, Emilio D. Poggio

Research output: Contribution to journalArticlepeer-review

60 Scopus citations

Abstract

Living donor renal allograft survival is superior to that achieved from deceased donors, although graft outcome is suboptimal in some of these patients. In an effort to identify the subset of patients at high risk for poor outcomes we studied donor risk factors in 248 living kidney donor-recipient pairs. Unadjusted donor I-iothalamate GFR (iGFR), donor age more than 45 years, donor total cholesterol level less than 200 mg/dL, and donor systolic blood pressure (SBP) less than 120 mm Hg were correlated with allograft estimated glomerular filtration rate (eGFR), and incidence of acute rejection (AR), delayed graft function and/or graft loss at 2 years posttransplantation. Donor iGFR less than 110 mL/min (slope=-7.40, P<0.01), donors more than 45 years (slope=-8.76, P<0.01), donor total cholesterol levels more than 200 mg/dL (slope=-10.03, P<0.01), and SBP more than 120 mm Hg (slope=-5.60, P=0.03) were associated with lower eGFR. By multivariable linear regression analysis these variables remained independently associated with lower eGFR, and poorer outcomes. The increasing number of donor factors (age, iGFR, cholesterol, and blood pressure) was directly associated with worse posttransplant eGFR (P<0.01). In conclusion, our data suggest that routine assessment of living donor parameters could supplement the consideration of recipient characteristics in predicting posttransplant risk of graft injury/dysfunction.

Original languageEnglish (US)
Pages (from-to)593-599
Number of pages7
JournalTransplantation
Volume83
Issue number5
DOIs
StatePublished - Mar 1 2007

Keywords

  • Age
  • Blood pressure
  • Cholesterol
  • Glomerular filtration rate
  • Graft outcome
  • Kidney transplantation
  • Living donor

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