Kidney Week

Abstract: SA-PO795

Long-Term Outcomes of Living Related Kidney Donation for Alport Syndrome Spectrum: A Propensity-Score Matched Analysis

Session Information

• Transplantation: Clinical - Pretransplant Assessment and Living Donors
  November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Caliskan, Yasar, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Yasar Caliskan,

• Oto, Ozgur Akin, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Ozgur Akin Oto,

• Safak, Seda, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Seda Safak,

• Mirioglu, Safak, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Safak Mirioglu,

• Yelken, Berna, Koc Universitesi, Istanbul, Istanbul, Turkey

Berna Yelken,

• Velioglu, Arzu, Marmara Universitesi, Istanbul, Istanbul, Turkey

Arzu Velioglu,

• Dirim, Ahmet Burak, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Ahmet Burak Dirim,

• Guller, Nurana, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Nurana Guller,

• Yildiz, Abdulmecit, Bursa Uludag Universitesi, Bursa, Turkey

Abdulmecit Yildiz,

• Ersoy, Alparslan, Bursa Uludag Universitesi, Bursa, Turkey

Alparslan Ersoy,

• Turkmen, Aydin, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Aydin Turkmen,

• Yazici, Halil, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Halil Yazici,

• Lentine, Krista L., Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Krista L. Lentine,

Background

We examined a cohort of living related donors (LRDs) to recipients with Alport syndrome spectrum (AS) and compared their outcomes with a control group to improve understanding of the clinical course and outcomes of living donation in this context.

Methods

LRDs of AS recipients (ASLD group) and propensity score-matched control LDs without any family history of AS (non-ASLD group) were followed for major cardiac events (MACE), death, post-donation eGFR and proteinuria.

Results

Long-term outcomes over 12.5 (IQR,5.0-16.7) years were evaluated in 27 and 29 LDs from ASLD and non-ASLD groups, respectively (Table 1). During follow-up, 5 LDs (18.5%) in ASLD developed MACE after 5.5 (IQR,4.5-10.3) years, whereas only two LDs in non-ASLD group developed MACE (p=0.19) (Table 1). New-onset hypertension was higher in ASLD (51.9%) compared to the control group (24.2%) (p=0.03). Three donors in ASLD and 2 donors in non-ASLD group who developed new-onset hypertension died during follow-up (p=0.58). MACE rate was significantly higher in donors who developed hypertension after donation (0% vs 33.3%, p<0.001). There were no differences between study groups regarding last eGFR and proteinuria levels (p=0.42 and p=0.26, respectively). When long-term outcomes of donors with COL4A3-5 variants were evaluated, of 6 ASLDs with associated variants only a donor with COL4A3 and another donor with COL4A4 heterozygous variant developed hypertension and MACE (Table 2).

Conclusion

Although the risk of kidney disease can be minimised by careful donor evaluation, our findings suggest that hypertension risk after the donation is higher than expected in related donors of recipients with AS.