Kidney Week

Abstract: TH-PO971

Liberalization of Living Kidney Donor Selection Criteria and Long-Term Outcomes

Session Information

• Live Donor Outcomes and Kidney Transplantation in Pediatric and Ethnic/Racial Groups
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Transplantation

• 1702 Transplantation: Clinical and Translational

Authors

• van Londen, Marco, University Medical Center Groningen, Groningen, Netherlands

Marco van Londen,

• Wijninga, Anthony Brian, University Medical Center Groningen, Groningen, Netherlands

Anthony Brian Wijninga,

• de Jong, Maarten A., University Medical Center Groningen, Groningen, Netherlands

Maarten A. de Jong,

• Berger, Stefan P., University Medical Center Groningen, Groningen, Netherlands

Stefan P. Berger,

• Navis, Gerjan, University Medical Center Groningen, Groningen, Netherlands

Gerjan Navis,

• De Borst, Martin H., University Medical Center Groningen, Groningen, Netherlands

Martin H. De Borst,

Background

To meet the increasing demand for donor organs, selection criteria for living kidney donors have been liberalized. The impact of this liberalization is largely unknown. We compared long-term outcomes of living kidney donors over different time periods.

Methods

In this single-center prospective cohort study, we divided 323 living kidney donors into two groups according to the year of donation (1987-2004, n=81 vs. 2005-2012, n=242). We analyzed differences in age, sex, measured GFR (mGFR, continuous iothalamate), systolic blood pressure, proteinuria, BMI, and number of antihypertensives among the two groups (1987-2004 vs. 2005-2012) at baseline and at 5 years post-donation, using Student’s t-test and Pearson’s Chi-square test.

Results

At donation, sex (41% vs. 50%, p=0.13) and mGFR (105±14 vs. 103±16 ml/min/1.73m², p=0.23) were similar among both groups. However, donors who donated after 2004 were older (46±10 vs. 53±10, p<0.001), had a higher systolic blood pressure (122±11 vs. 129±14 mmHg, p<0.001), and BMI (25±4 vs. 27±4 kg/m², p=0.002), and more often used antihypertensives (5% vs. 15%, p=0.04). At 5 years post-donation, individuals who donated after 2004 had a lower mGFR (72±11 vs. 68±12 ml/min/1.73m2, p=0.01) and a more pronounced mGFR reduction compared with pre-donation (-35±12 vs. -39±15 ml/min, p=0.01). There were no differences in systolic blood pressure (126±13 vs. 128±14 mmHg, p=0.44), proteinuria (1.1±2.0 vs. 0.8±1.0 g/24h, p=0.34), BMI (27±4 vs. 27±4 kg/m², p=0.19) or number of antihypertensives at 5 years post-donation.

Conclusion

Our study confirms a trend in the liberalization of living kidney donors, at least regarding age and blood pressure at donation. Moreover, we observed a small but significant reduction in long-term renal function in living kidney donors who donated more recently. Future studies with longer follow-up should address the impact of donor liberalization on outcomes.

Funding

• Government Support - Non-U.S.