Abstract: TH-PO937

Hypertension, Renal Function, and Histologic Changes in Living Kidney Transplant Recipients from Hypertensive Donors

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Dienemann, Thomas, University of Erlangen , Erlangen, Germany
  • Schellenberg, Jana, Uniklinikum Erlangen, Nürnberg, Germany
  • Amann, Kerstin U., University of Erlangen , Erlangen, Germany
  • Daniel, Christoph, University Erlangen-Nürnberg, Erlangen, Germany
  • Heller, Katharina M., Friedrich - Alexander University Erlangen - N?rnberg, Erlangen, Germany
Background

Due to the ever-increasing organ shortage, centers increasingly accept living kidney donors with preexisting hypertension despite concerns over donor safety for over two decades. Data on outcomes in recipients of such kidneys of hypertensive living donors is very limited. In the present study, we examined we examined whether use of hypertensive living kidney donors associates with kidney function, blood pressure and histologic changes at transplantation and one year after transplantation in living kidney transplant recipients

Methods

Retrospective single center analysis of 182 living kidney transplant recipients (age>18; transplant date 2008-2015). Hypertension in donors was defined as ABPM above 135/85 or ≥1 BP medication. Recipients eGFR was measured at 1 year using the MDRD equation. All renal biopsies were examined by a blinded pathologist using the recently advocated total renal chronicity score (TRCS). Logistic regression models adjusted for multiple potential confounders were used to examine the relationship of hypertensive donor on blood pressure and renal function in recipients.

Results

One year follow up was complete in 180 patients including a biopsy at transplant, in 131 patients a protocol biopsy 12 months after transplant was also available. 138 recipients had normotensive donors (dNT), 42 recipients had hypertensive donors (dHT). There were no differences in age, sex, BMI, and eGFR between recipients from dNT and dHT. Average systolic and diastolic blood pressure in dHT was significantly higher (131/76 vs 119/72 mmHg in dNT, p < 0.001 for both). Adjusted for multiple confounders there was no difference in blood pressure, number of antihypertensive drugs, and eGFR in recipients at 1 year. The TRCS showed no difference at time of transplant and at 1 year after transplantation

Conclusion

In our cohort, recipients of a living kidney transplant from hypertensive donors showed no differences in blood pressure, renal function or the TRCS after a 1 year follow up. Prudent selection in terms of accepting hypertensive donors remains mandatory. However longer follow up data is needed to assess potential long term effects which might affect the commonly superior results of living kidney transplantation in recipients of such kidneys.