Inferior long-term allograft and patient outcomes among recipients of offspring living donor kidneys

摘要

While offspring-to-parent living donor kidney transplantations may represent an ideal donor-recipient combination to optimize long-term transplant outcomes, the gender-specific long-term success of these transplants remains unclear. We hypothesize that allograft and recipient survival in offspring-to-parent living donor kidney transplantation differs between men and women due to donor-specific alloimmunization during pregnancy. We retrospectively analyzed long-term allograft and patient survival among men and women who received an offspring living donor kidney compared to those who received other haplotype-matched living donor kidneys. By multivariable Cox proportional hazards modeling of Organ Procurement and Transplantation Network data from 2001 to 2015, we found that both men and women who received offspring living donor kidneys had significantly increased mortality compared to recipients who received non-offspring living donor kidneys. While male recipients of any living donor kidney had greater risk of mortality and allograft failure compared to females, there was no significant difference in all-cause allograft failure or mortality in male versus female recipients of offspring living donor kidney transplantations. Our analysis demonstrated no significant interaction between recipient gender and donor offspring status. We conclude that non-offspring living donors should be considered whenever feasible for both men and women with multiple donor options.