Risk factors among donor characteristics which affect graft outcome in paired kidney transplantation

The goal of this study was to identify risk factors among donor characteristics which affect short- and long-term graft outcomes and patient survivals.

This is a retrospective analysis of cases where the kidneys were retrieved from the same donor. We evaluated donor variables including age, sex, cytomegalovirus (CMV) status, infection, blood pressure, electrolyte, urine output, transfusion, cause of death, creatinine level, and cold ischemia time. We also analyzed recipient outcomes and graft function.

We analyzed 21 donor and 42 recipient records. The majority of donors (85.0%) were <50 years old. The mean donor urine output was 169 mL/h. Delayed graft function was not affected by donor variables. The serum Na and CMV status of the donor were related to the occurrence of an acute rejection episode, but only CMV status showed a significant influence in the multivariate analysis. Among different groups of donor creatinine, better donor function (creatinine <1.0 vs >1.0 mg/dL) was associated with better posttransplantation graft function (creatinine 1.18 vs 2.26 mg/dL). In long-term graft function and survival, donor creatinine showed no significant impact. According to the sequence of transplantation, recipients were divided into group 1 (first kidney transplantation: mean ischemia time, 207 minutes) vs group 2 (second kidney transplantation: mean ischemia time, 441 minutes). Group 1 showed better graft function and survival time.

Only CMV status of the donor was related to acute rejection episodes after renal transplantation. The donor creatinine data also affected initial posttransplantation creatinine. There was no significant difference in long-term graft survival among various levels of donor kidney function.