Recipient Outcomes From Nondirected Live Kidney Donors: A UK-based Cohort Study

Jay Nath; Kamlesh Patel; Melanie Field; James Hodson; Adnan Sharif; Nicholas G Inston; Andrew R Ready

doi:10.1097/TXD.0000000000000847

Recipient Outcomes From Nondirected Live Kidney Donors: A UK-based Cohort Study

Jay Nath, Kamlesh Patel, Melanie Field, James Hodson, Adnan Sharif, Nicholas G Inston, Andrew R Ready

Research output: Contribution to journal › Article › peer-review

121 Downloads (Pure)

Abstract

Background: Increasing numbers of patients with end-stage renal failure are receiving kidneys from nondirected kidney donors (NKDs), also known as altruistic donors. Transplant outcomes for recipients of such kidneys are largely inferred from studies on specified kidney donors (SKDs), which may be inaccurate due to differences in donor, recipient and transplant specific factors. We report the outcomes for recipients of NKD in the United Kingdom.

Methods: Outcomes for 6861 patients receiving a living donor kidney transplant between January 2007 and December 2014 were analyzed using both the National Health Service Blood and Transplant and the UK Renal Registry datasets. Graft and patient outcomes were compared for patients receiving NKD and SKD organs using univariable and multivariable analyses.

Results: There was significant discordance between the NKD and SKD donors and recipients. These included increased donor age (median, 58 years vs 47 years; P < 0.001) and higher rates of hemodialysis and previous transplants in the NKD group (both P < 0.001). Despite such markers of increased risk among both donors and recipients of NKD kidneys, there was no difference in graft survival on univariable (hazard ratio, 1.20; 95% confidence interval, 0.77-1.86; P = 0.419) or multivariable analysis (hazard ratio, 1.13; 95% confidence interval, 0.65-1.95; P = 0.665).

Conclusions: Despite some markers of transplant complexity, nondirected kidney donor organs are an excellent source of organs for transplantation.

Original language	English
Pages (from-to)	e406
Journal	Transplantation direct
Volume	4
Issue number	12
DOIs	https://doi.org/10.1097/TXD.0000000000000847
Publication status	Published - 1 Dec 2018

Access to Document

10.1097/TXD.0000000000000847Licence: Creative Commons: Attribution-NonCommercial-NoDerivs (CC BY-NC-ND)

Nath_et_al_2018_Recipient_Outcomes_From_Nondirected_Live_Kidney_Transplantation_DirectFinal published version, 349 KBLicence: Creative Commons: Attribution-NonCommercial-NoDerivs (CC BY-NC-ND)

Cite this

@article{5d396a09d49e463190b030db6f57485c,

title = "Recipient Outcomes From Nondirected Live Kidney Donors: A UK-based Cohort Study",

abstract = "Background: Increasing numbers of patients with end-stage renal failure are receiving kidneys from nondirected kidney donors (NKDs), also known as altruistic donors. Transplant outcomes for recipients of such kidneys are largely inferred from studies on specified kidney donors (SKDs), which may be inaccurate due to differences in donor, recipient and transplant specific factors. We report the outcomes for recipients of NKD in the United Kingdom.Methods: Outcomes for 6861 patients receiving a living donor kidney transplant between January 2007 and December 2014 were analyzed using both the National Health Service Blood and Transplant and the UK Renal Registry datasets. Graft and patient outcomes were compared for patients receiving NKD and SKD organs using univariable and multivariable analyses.Results: There was significant discordance between the NKD and SKD donors and recipients. These included increased donor age (median, 58 years vs 47 years; P < 0.001) and higher rates of hemodialysis and previous transplants in the NKD group (both P < 0.001). Despite such markers of increased risk among both donors and recipients of NKD kidneys, there was no difference in graft survival on univariable (hazard ratio, 1.20; 95% confidence interval, 0.77-1.86; P = 0.419) or multivariable analysis (hazard ratio, 1.13; 95% confidence interval, 0.65-1.95; P = 0.665).Conclusions: Despite some markers of transplant complexity, nondirected kidney donor organs are an excellent source of organs for transplantation.",

author = "Jay Nath and Kamlesh Patel and Melanie Field and James Hodson and Adnan Sharif and Inston, {Nicholas G} and Ready, {Andrew R}",

year = "2018",

month = dec,

day = "1",

doi = "10.1097/TXD.0000000000000847",

language = "English",

volume = "4",

pages = "e406",

journal = "Transplantation direct",

issn = "2373-8731",

publisher = "Lippincott Williams and Wilkins",

number = "12",

}

TY - JOUR

T1 - Recipient Outcomes From Nondirected Live Kidney Donors

T2 - A UK-based Cohort Study

AU - Nath, Jay

AU - Patel, Kamlesh

AU - Field, Melanie

AU - Hodson, James

AU - Sharif, Adnan

AU - Inston, Nicholas G

AU - Ready, Andrew R

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Increasing numbers of patients with end-stage renal failure are receiving kidneys from nondirected kidney donors (NKDs), also known as altruistic donors. Transplant outcomes for recipients of such kidneys are largely inferred from studies on specified kidney donors (SKDs), which may be inaccurate due to differences in donor, recipient and transplant specific factors. We report the outcomes for recipients of NKD in the United Kingdom.Methods: Outcomes for 6861 patients receiving a living donor kidney transplant between January 2007 and December 2014 were analyzed using both the National Health Service Blood and Transplant and the UK Renal Registry datasets. Graft and patient outcomes were compared for patients receiving NKD and SKD organs using univariable and multivariable analyses.Results: There was significant discordance between the NKD and SKD donors and recipients. These included increased donor age (median, 58 years vs 47 years; P < 0.001) and higher rates of hemodialysis and previous transplants in the NKD group (both P < 0.001). Despite such markers of increased risk among both donors and recipients of NKD kidneys, there was no difference in graft survival on univariable (hazard ratio, 1.20; 95% confidence interval, 0.77-1.86; P = 0.419) or multivariable analysis (hazard ratio, 1.13; 95% confidence interval, 0.65-1.95; P = 0.665).Conclusions: Despite some markers of transplant complexity, nondirected kidney donor organs are an excellent source of organs for transplantation.

AB - Background: Increasing numbers of patients with end-stage renal failure are receiving kidneys from nondirected kidney donors (NKDs), also known as altruistic donors. Transplant outcomes for recipients of such kidneys are largely inferred from studies on specified kidney donors (SKDs), which may be inaccurate due to differences in donor, recipient and transplant specific factors. We report the outcomes for recipients of NKD in the United Kingdom.Methods: Outcomes for 6861 patients receiving a living donor kidney transplant between January 2007 and December 2014 were analyzed using both the National Health Service Blood and Transplant and the UK Renal Registry datasets. Graft and patient outcomes were compared for patients receiving NKD and SKD organs using univariable and multivariable analyses.Results: There was significant discordance between the NKD and SKD donors and recipients. These included increased donor age (median, 58 years vs 47 years; P < 0.001) and higher rates of hemodialysis and previous transplants in the NKD group (both P < 0.001). Despite such markers of increased risk among both donors and recipients of NKD kidneys, there was no difference in graft survival on univariable (hazard ratio, 1.20; 95% confidence interval, 0.77-1.86; P = 0.419) or multivariable analysis (hazard ratio, 1.13; 95% confidence interval, 0.65-1.95; P = 0.665).Conclusions: Despite some markers of transplant complexity, nondirected kidney donor organs are an excellent source of organs for transplantation.

U2 - 10.1097/TXD.0000000000000847

DO - 10.1097/TXD.0000000000000847

M3 - Article

C2 - 30584587

SN - 2373-8731

VL - 4

SP - e406

JO - Transplantation direct

JF - Transplantation direct

IS - 12

ER -

Recipient Outcomes From Nondirected Live Kidney Donors: A UK-based Cohort Study

Abstract

Access to Document

Fingerprint

Cite this