11-year single-center experience in living-donor kidney transplantation in Poland

Living-donor kidney transplantation (LDKT) is a viable option that is characterized by better short- and long-term results than cadaver-donor kidney transplantation (CKT). In Poland number of LDKT is low (2%-3%). We collected data on all 29 LDKTs performed in our center between 1999 and 2010; 82.7% were obtained from living related donors. The mean recipient age was 34.4±12.8 years (range, 15-58) and mean donor age was 48.5±7 years. Most donors were women (n=17; 62%). In 3 cases the LDKT was a second transplantation. The mean numbers of HLA class I and II mismatches were 2.18±0.98 and 0.93±0.6 respectively. The mean total ischemia time was 3.22±1.74 hours. Induction therapy included antithymocyte globulin daclizumab 4; (13.7%) (n=7; 24.1%); 27.6% of recipients were placed on cyclosporine based immunosuppression and the remaining 72.4% on tacrolimus with 69% also receiving mycophenolate mofetil. All recipients were prescribed steroids. Delayed graft function was observed in 3 cases and an acute rejection episode in 4 subjects. One-year patient and graft survivals were both 100% (98% and 83% for CKT). Five-year patient and graft survival were 100% and 89.6%, respectively, compared with 83% and 69% in CKT. The mean serum creatinine levels at 1, 6, 12, and 60 months were 1.59±0.4, 1.51±0.3, 1.51±0.4 and 1.49±0.3 mg/dL respectively. Our results, albeit concerning a small group of patients, confirmed excellent outcomes of LDKT, which should be actively promoted in our country.