Higher Renal Allograft Function in Deceased-Donor Kidney Transplantation Rather Than in Living-Related Kidney Transplantation

摘要

ObjectivesTo compare the clinical outcome of kidney transplantation from living-related and deceased donors. Patients and methodsConsecutive adult kidney transplants from living-related or deceased donors from February 2004 to December 2015 in a single center were enrolled for retrospective analysis. Estimated glomerular filtration rate (eGFR) was compared with linear mixed models controlling the effect of repeated measurement at different time points. ResultsThere were 536 living-related and 524 deceased donor kidney transplants enrolled. The 1-year, 3-year, and 5-year graft survival rates were 98.8%, 98.5% and 97.2% in living-related kidney transplantation (KTx), and 94.9%, 91.3% and 91.3% in deceased donor KTx (log-rank,P?< .001). A significantly higher incidence of delayed graft function (DGF) was observed in deceased donor KTx (20.6% vs 2.6%,P?< .001). eGFR in deceased donor KTx was significantly higher than that in living-related KTx (68.0 ± 23.7 vs 64.7 ± 17.9 mL/min/1.73 m2at 1 year postoperation, 70.1 ± 23.3 vs 64.3 ± 19.3 mL/min/1.73 m2at 2 years postoperation, and 72.5 ± 26.2 vs 65.2 ± 20.4 mL/min/1.73 m2at 3 years postoperation;P?< .001). The donor age was significantly higher in living-related KTx group (47.5 ± 11.0 vs 31.1 ± 14.4 years,P?< .001). ConclusionLiving-related graft survival is superior to deceased graft survival at this center, while better 5-year renal allograft function is obtained in deceased donor KTx patients, which may be attributable to the higher age of living-related donors.