Abstract: FR-PO1030

Impact of Modifiable and Non-Modifiable Factors on Patient and Kidney Allograft Outcomes: A Twin Kidney Analysis of Left/Right Deceased Donor Kidney Pairs

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Otto, Natalie M., Charite Campus Virchow Clinic, Berlin, Germany
  • Schachtner, Thomas, Charite Campus Virchow Clinic, Berlin, Germany
  • Reinke, Petra, Charité, Campus Virchow Klinikum, Berlin, Germany
Background

The impact of donor factors on kidney allograft outcomes and infectious complications has been suggested in many previous studies. However, analysis of left or right donor kidney pairs are rarely performed, although individual recipients risk factors may be analyzed in a paired difference test and significantly reduce donor cofounders.

Methods

Here, we studied all transplanted left/right deceased donor kidney pairs at our center between 2003 and 2015. A total of 174 paired kidney transplantations were performed from 87 donors. To account for identical donor characteristics among left/right donor kidney pairs a paired difference testing was performed.

Results

Patient survival, allograft survival and allograft function were not correlated among left/right donor kidney pairs (p>0.05). In a paired analysis recipient age, gender, BMI, preformed diabetes, cold ischemia time, HLA-match did not impact allograft outcomes among left/right kidney pairs (p<0.05). Delayed allograft function was more likely detected in both kidney pairs than one pair only (p<0.05). Male gender was associated with delayed allograft function among kidney pairs (p=0.021). Primary nonfunction, acute cellular rejection, BK viremia, EBV viremia, sepsis, and cancer were more likely detected in one pair only (p<0.05). All 20 cases of BK viremia were detected in one pair only (p<0.001). A higher number of HLA-mismatches was associated with BK viremia among kidney pairs (p=0.006). Re-transplantation in one pair was associated with a higher incidence of acute cellular rejection.

Conclusion

Despite an increased incidence of delayed allograft function in left/right kidney pairs, our results suggest low impact of donor factors on patient and allograft outcomes. In contrast, our data suggest a strong impact of individual recipient characteristics as common infectious complications as CMV or BKV don’t appear solely attributable to donor origin, but to impaired immunity of the recipient.