Abstract: FR-PO1172
Postdonation Systolic Blood Pressure Trajectories After Living Kidney Donation and Paired Recipient Outcomes: A Nationwide Prospective Cohort Study from KOTRY
Session Information
- Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Yoon, Hye Eun, The Catholic University of Korea College of Medicine, Seocho-gu, Seoul, Korea (the Republic of)
- Lee, Yu ho, Kyung Hee University, Dongdaemun-gu, Seoul, Korea (the Republic of)
- Hwang, Hyeon Seok, Kyung Hee University, Dongdaemun-gu, Seoul, Korea (the Republic of)
Background
Donor nephrectomy increases susceptibility to hypertension. However, post-donation systolic blood pressure (SBP) trajectories in living donors remain poorly characterized and their implications for paired kidney transplant recipients (KTRs) uncertain.
Methods
We analyzed 3,844 living donor–recipient pairs from a nationwide, multicenter, prospective, cohort. Longitudinal systolic blood pressure (SBP) measurements of donors after donation were analyzed using latent class mixture modeling to identify SBP trajectories. Donor and paired recipient outcomes, including incident and uncontrolled hypertension, and eGFR changes, were compared.
Results
We identified two donor SBP trajectory classes with linear patterns: Class 1 (95.1%), gradual increase; Class 2 (4.9%), steeper increase. Class 2 donors showed higher cumulative incidence of new-onset hypertension, diabetes, and eGFR <60 mL/min/1.73 m (all p<0.001). Among recipients without pretransplant hypertension, class 2 donor recipients had a higher risk of incident hypertension (adjusted hazard ratio 2.47; 95% confidence interval 1.31–4.66). Restricted cubic spline analyses showed a dose–response relationship, with progressively higher incident hypertension risk as the posterior probability of class 2 increased. Among recipients with pre-existing hypertension, donor SBP trajectory was not associated with uncontrolled hypertension; however, class 2 donor recipients showed greater eGFR decline (adjusted β = −0.68; 95% confidence interval −1.08 to −0.27).
Conclusion
A steeper post-donation donor SBP trajectory was associated with adverse donor outcomes, incident hypertension in KTRs without pretransplant hypertension, and greater eGFR decline in KTRs with pretransplant hypertension. These findings indicate that post-donation donor SBP trajectories capture shared risk across the donor–recipient pair.