Abstract: TH-PO986

The Effects of Marriage Duration after Transplantation on Graft Outcomes in Spousal Donor Kidney Transplantation

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Yu, Mi-yeon, Seoul national university hospital, Seoul, Korea (the Republic of)
  • Park, Ji In, Kangwon National University Hospital, Chuncheon-si,, Korea (the Republic of)
  • Cho, Hyunjeong, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
Background

It is well known that graft survival rate in spousal donor kidney transplantation (SKT) is similar to that of living related donor kidney transplantation (LRKT) despite poor histocompatibility and older age. Marriage is a distinctive feature of spousal kidney donation and other living unrelated kidney donation. Although married people live longer and healthier than singles due to their closest environmental and habitual relationship, the effect of marriage on graft outcome has not been evaluated.

Methods

In a retrospective cohort study, we recruited patients undergone living donor kidney transplantation at Seoul National University Hospital between January 2000 and February 2016. We divided patients into three groups as follows: SKT, LRKT and other living unrelated kidney donor transplantation (LURKT). For spousal donors, the marriage duration after transplantation (MDAT) was surveyed by both personal interview and telephone questionnaire. Outcome was biopsy proven acute rejection (BPAR), graft survival (GS) and patient survival (PS).

Results

A total of 824 living donor kidney transplantation recipients were included. Among them, LRKT was most common with 68.8 %, followed by SKT with 22.3 %, and LURKT with 8.9 %. SKT group received their allografts from donors with older age (median age 46.0), more female sex (65.8%), more ABO incompatibilities and higher HLA mismatches than LRKT or LURKT groups. They tended to receive more preemptive transplantation. In[S1] the Kaplan-Meier curve, SKT revealed lower BPAR free survival rate than LRKT, whereas GS and PS were not different. Among SKT, longer MDAT was demonstrated as a novel protective factor for BPAR even after adjustment (adjusted HR 0.244, 95% CI 0.121-0.493, P<0.001), although it did not affect GS or PS.

Conclusion

We demonstrated that graft and patient survival rate of SKT was not inferior to LRKT, despite their immunologic risk. Moreover, we found that longer MDAT was a novel protective factor for BPAR free survival rate. Not only immunologic similarity but also habitual similarity between donor and recipient may influence on graft outcome after kidney transplantation.