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Abstract: FR-PO824

A Propensity-Score Matched Analysis of Long-Term Outcomes for Living Kidney Donation in Alternative Complement Pathway Diseases

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Caliskan, Yasar, Saint Louis University School of Medicine, Saint Louis, Missouri, United States
  • Safak, Seda, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey
  • Oto, Ozgur Akin, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey
  • Velioglu, Arzu, Marmara Universitesi, Istanbul, Istanbul, Turkey
  • Yelken, Berna, Koc Universitesi, Istanbul, Istanbul, Turkey
  • Dirim, Ahmet Burak, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey
  • Yildiz, Abdulmecit, Bursa Uludag Universitesi, Bursa, Turkey
  • Mirioglu, Safak, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey
  • Guller, Nurana, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey
  • Yazici, Halil, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey
  • Ersoy, Alparslan, Bursa Uludag Universitesi, Bursa, Turkey
  • Turkmen, Aydin, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey
  • Lentine, Krista L., Saint Louis University School of Medicine, Saint Louis, Missouri, United States
Background

We examined the clinical course of living donors (LDs) to recipients with atypical hemolytic-uremic syndrome (aHUS) and C3 glomerulopathy (C3G) and compared their outcomes with a control group to improve understanding of the clinical course and outcomes of living donation in this context.

Methods

The cohort of LDs of aHUS/C3G recipients (Complement-LD group) and propensity score-matched control LDs without any family history of aHUS/C3G (Control-LD group) were retrospectively identified from data at 4 transplant centers (2003-2021). LD were followed for major cardiac events (MACE), de novo hypertension, cancer, death, post-donation eGFR and proteinuria.

Results

The cohort comprised 24 LD to recipients with aHUS (46%) and C3G (54%) including 18 related LDs. Long-term outcomes were compared with propensity score-matched control group over 5 years (IQR,3-11.8) follow-up. During follow-up, none of the LDs in complement-LD group developed MACE whereas two LDs in control-LD group developed MACE (18.5%) after 8 (IQR,2.6-12.8) years (p=0.15). New-onset hypertension was similar between groups (20.8% vs 25%, p=0.73) (Table 1). There were no differences between study groups regarding last eGFR and proteinuria levels (p=0.11 and p=0.40, respectively). None of the donors developed kidney failure (eGFR<15ml/min/1.73m2 or dialysis). In complement-LD group a related donor developed gastric cancer and another related donor developed a brain tumor and died at 4th year after donation (Table 1).

Conclusion

The risks of kidney failure, cardiovascular disease, de novo aHUS and C3G in carefully selected LD to recipients with aHUS and C3G appear to be low. Cancer development in related LDs of recipients with complement mediated disease may need further investigation.