The association of living donor source with patient and graft survival among kidney transplant recipients in the ERA-EDTA Registry – a retrospective study

Samar Abd ElHafeez; Marlies Noordzij; Anneke Kramer; Samira Bell; Emilie Savoye; José Maria Abad Diez; Torbjörn Lundgren; Anna Varberg Reisæter; Julia Kerschbaum; Carmen Santiuste de Pablos; Fernanda Ortiz; Frederic Collart; Runólfur Pálsson; Mustafa Arici; James G. Heaf; Ziad A. Massy; Kitty J. Jager

doi:10.1111/tri.13759

The association of living donor source with patient and graft survival among kidney transplant recipients in the ERA-EDTA Registry – a retrospective study

Samar Abd ElHafeez, Marlies Noordzij, Anneke Kramer, Samira Bell, Emilie Savoye, José Maria Abad Diez, Torbjörn Lundgren, Anna Varberg Reisæter, Julia Kerschbaum, Carmen Santiuste de Pablos, Fernanda Ortiz, Frederic Collart, Runólfur Pálsson, Mustafa Arici, James G. Heaf, Ziad A. Massy, Kitty J. Jager

University of Iceland, Landspitali

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

Abstract

In this study we aimed to compare patient and graft survival of kidney transplant recipients who received a kidney from a living-related donor (LRD) or living-unrelated donor (LUD). Adult patients in the ERA-EDTA Registry who received their first kidney transplant in 1998–2017 were included. Ten-year patient and graft survival were compared between LRD and LUD transplants using Cox regression analysis. In total, 14 370 patients received a kidney from a living donor. Of those, 9212 (64.1%) grafts were from a LRD, 5063 (35.2%) from a LUD and for 95 (0.7%), the donor type was unknown. Unadjusted five-year risks of death and graft failure (including death as event) were lower for LRD transplants than for LUD grafts: 4.2% (95% confidence interval [CI]: 3.7–4.6) and 10.8% (95% CI: 10.1–11.5) versus 6.5% (95% CI: 5.7–7.4) and 12.2% (95% CI: 11.2–13.3), respectively. However, after adjusting for potential confounders, associations disappeared with hazard ratios of 0.99 (95% CI: 0.87–1.13) for patient survival and 1.03 (95% CI: 0.94–1.14) for graft survival. Unadjusted risk of death-censored graft failure was similar, but after adjustment, it was higher for LUD transplants (1.19; 95% CI: 1.04–1.35). In conclusion, patient and graft survival of LRD and LUD kidney transplant recipients was similar, whereas death-censored graft failure was higher in LUD. These findings confirm the importance of both living kidney donor types.

Original language	English
Pages (from-to)	76-86
Number of pages	11
Journal	Transplant international
Volume	34
Issue number	1
DOIs	https://doi.org/10.1111/tri.13759
Publication status	Published - 6 Oct 2020

Bibliographical note

The ERA‐EDTA Registry is funded by the European Renal Association‐European Dialysis and Transplant Association (ERA‐EDTA). This article was written by S. Abd ElHafeez, M. Noordzij, A. Kramer, S. Bell, E. Savoye, J.M. Abad Diez, T. Lundgren, A.V. Reisæter, J. Kerschbaum, C. Santiuste de Pablos, F. Ortiz, F. Collart, R. Palsson, M. Arici, J.G. Heaf, Z.A. Massy and K.J. Jager on behalf of the ERA‐EDTA Registry which is an official body of the ERA‐EDTA (European Renal Association – European Dialysis and Transplant Association). Publisher Copyright: © 2020 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT

Other keywords

Adult
Edetic Acid
Graft Rejection
Graft Survival
Humans
Kidney Transplantation
Living Donors
Registries
Retrospective Studies
donor source
graft survival
kidney transplantation
living donation
patient survival

Access to Document

10.1111/tri.13759

Cite this

Abd ElHafeez, S., Noordzij, M., Kramer, A., Bell, S., Savoye, E., Abad Diez, J. M., Lundgren, T., Reisæter, A. V., Kerschbaum, J., Santiuste de Pablos, C., Ortiz, F., Collart, F., Pálsson, R., Arici, M., Heaf, J. G., Massy, Z. A., & Jager, K. J. (2020). The association of living donor source with patient and graft survival among kidney transplant recipients in the ERA-EDTA Registry – a retrospective study. Transplant international, 34(1), 76-86. https://doi.org/10.1111/tri.13759

@article{7bf230b7ccbb44738b3cf3bc0374bb73,

title = "The association of living donor source with patient and graft survival among kidney transplant recipients in the ERA-EDTA Registry – a retrospective study",

abstract = "In this study we aimed to compare patient and graft survival of kidney transplant recipients who received a kidney from a living-related donor (LRD) or living-unrelated donor (LUD). Adult patients in the ERA-EDTA Registry who received their first kidney transplant in 1998–2017 were included. Ten-year patient and graft survival were compared between LRD and LUD transplants using Cox regression analysis. In total, 14 370 patients received a kidney from a living donor. Of those, 9212 (64.1\%) grafts were from a LRD, 5063 (35.2\%) from a LUD and for 95 (0.7\%), the donor type was unknown. Unadjusted five-year risks of death and graft failure (including death as event) were lower for LRD transplants than for LUD grafts: 4.2\% (95\% confidence interval [CI]: 3.7–4.6) and 10.8\% (95\% CI: 10.1–11.5) versus 6.5\% (95\% CI: 5.7–7.4) and 12.2\% (95\% CI: 11.2–13.3), respectively. However, after adjusting for potential confounders, associations disappeared with hazard ratios of 0.99 (95\% CI: 0.87–1.13) for patient survival and 1.03 (95\% CI: 0.94–1.14) for graft survival. Unadjusted risk of death-censored graft failure was similar, but after adjustment, it was higher for LUD transplants (1.19; 95\% CI: 1.04–1.35). In conclusion, patient and graft survival of LRD and LUD kidney transplant recipients was similar, whereas death-censored graft failure was higher in LUD. These findings confirm the importance of both living kidney donor types.",

keywords = "Adult, Edetic Acid, Graft Rejection, Graft Survival, Humans, Kidney Transplantation, Living Donors, Registries, Retrospective Studies, donor source, graft survival, kidney transplantation, living donation, patient survival",

author = "\{Abd ElHafeez\}, Samar and Marlies Noordzij and Anneke Kramer and Samira Bell and Emilie Savoye and \{Abad Diez\}, \{Jos{\'e} Maria\} and Torbj{\"o}rn Lundgren and Reis{\ae}ter, \{Anna Varberg\} and Julia Kerschbaum and \{Santiuste de Pablos\}, Carmen and Fernanda Ortiz and Frederic Collart and Run{\'o}lfur P{\'a}lsson and Mustafa Arici and Heaf, \{James G.\} and Massy, \{Ziad A.\} and Jager, \{Kitty J.\}",

note = "The ERA‐EDTA Registry is funded by the European Renal Association‐European Dialysis and Transplant Association (ERA‐EDTA). This article was written by S. Abd ElHafeez, M. Noordzij, A. Kramer, S. Bell, E. Savoye, J.M. Abad Diez, T. Lundgren, A.V. Reis{\ae}ter, J. Kerschbaum, C. Santiuste de Pablos, F. Ortiz, F. Collart, R. Palsson, M. Arici, J.G. Heaf, Z.A. Massy and K.J. Jager on behalf of the ERA‐EDTA Registry which is an official body of the ERA‐EDTA (European Renal Association – European Dialysis and Transplant Association). Publisher Copyright: {\textcopyright} 2020 The Authors. Transplant International published by John Wiley \& Sons Ltd on behalf of Steunstichting ESOT",

year = "2020",

month = oct,

day = "6",

doi = "10.1111/tri.13759",

language = "English",

volume = "34",

pages = "76--86",

journal = "Transplant international",

issn = "0934-0874",

publisher = "Frontiers Media SA",

number = "1",

}

Abd ElHafeez, S, Noordzij, M, Kramer, A, Bell, S, Savoye, E, Abad Diez, JM, Lundgren, T, Reisæter, AV, Kerschbaum, J, Santiuste de Pablos, C, Ortiz, F, Collart, F, Pálsson, R, Arici, M, Heaf, JG, Massy, ZA & Jager, KJ 2020, 'The association of living donor source with patient and graft survival among kidney transplant recipients in the ERA-EDTA Registry – a retrospective study', Transplant international, vol. 34, no. 1, pp. 76-86. https://doi.org/10.1111/tri.13759

TY - JOUR

T1 - The association of living donor source with patient and graft survival among kidney transplant recipients in the ERA-EDTA Registry – a retrospective study

AU - Abd ElHafeez, Samar

AU - Noordzij, Marlies

AU - Kramer, Anneke

AU - Bell, Samira

AU - Savoye, Emilie

AU - Abad Diez, José Maria

AU - Lundgren, Torbjörn

AU - Reisæter, Anna Varberg

AU - Kerschbaum, Julia

AU - Santiuste de Pablos, Carmen

AU - Ortiz, Fernanda

AU - Collart, Frederic

AU - Pálsson, Runólfur

AU - Arici, Mustafa

AU - Heaf, James G.

AU - Massy, Ziad A.

AU - Jager, Kitty J.

N1 - The ERA‐EDTA Registry is funded by the European Renal Association‐European Dialysis and Transplant Association (ERA‐EDTA). This article was written by S. Abd ElHafeez, M. Noordzij, A. Kramer, S. Bell, E. Savoye, J.M. Abad Diez, T. Lundgren, A.V. Reisæter, J. Kerschbaum, C. Santiuste de Pablos, F. Ortiz, F. Collart, R. Palsson, M. Arici, J.G. Heaf, Z.A. Massy and K.J. Jager on behalf of the ERA‐EDTA Registry which is an official body of the ERA‐EDTA (European Renal Association – European Dialysis and Transplant Association). Publisher Copyright: © 2020 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT

PY - 2020/10/6

Y1 - 2020/10/6

N2 - In this study we aimed to compare patient and graft survival of kidney transplant recipients who received a kidney from a living-related donor (LRD) or living-unrelated donor (LUD). Adult patients in the ERA-EDTA Registry who received their first kidney transplant in 1998–2017 were included. Ten-year patient and graft survival were compared between LRD and LUD transplants using Cox regression analysis. In total, 14 370 patients received a kidney from a living donor. Of those, 9212 (64.1%) grafts were from a LRD, 5063 (35.2%) from a LUD and for 95 (0.7%), the donor type was unknown. Unadjusted five-year risks of death and graft failure (including death as event) were lower for LRD transplants than for LUD grafts: 4.2% (95% confidence interval [CI]: 3.7–4.6) and 10.8% (95% CI: 10.1–11.5) versus 6.5% (95% CI: 5.7–7.4) and 12.2% (95% CI: 11.2–13.3), respectively. However, after adjusting for potential confounders, associations disappeared with hazard ratios of 0.99 (95% CI: 0.87–1.13) for patient survival and 1.03 (95% CI: 0.94–1.14) for graft survival. Unadjusted risk of death-censored graft failure was similar, but after adjustment, it was higher for LUD transplants (1.19; 95% CI: 1.04–1.35). In conclusion, patient and graft survival of LRD and LUD kidney transplant recipients was similar, whereas death-censored graft failure was higher in LUD. These findings confirm the importance of both living kidney donor types.

AB - In this study we aimed to compare patient and graft survival of kidney transplant recipients who received a kidney from a living-related donor (LRD) or living-unrelated donor (LUD). Adult patients in the ERA-EDTA Registry who received their first kidney transplant in 1998–2017 were included. Ten-year patient and graft survival were compared between LRD and LUD transplants using Cox regression analysis. In total, 14 370 patients received a kidney from a living donor. Of those, 9212 (64.1%) grafts were from a LRD, 5063 (35.2%) from a LUD and for 95 (0.7%), the donor type was unknown. Unadjusted five-year risks of death and graft failure (including death as event) were lower for LRD transplants than for LUD grafts: 4.2% (95% confidence interval [CI]: 3.7–4.6) and 10.8% (95% CI: 10.1–11.5) versus 6.5% (95% CI: 5.7–7.4) and 12.2% (95% CI: 11.2–13.3), respectively. However, after adjusting for potential confounders, associations disappeared with hazard ratios of 0.99 (95% CI: 0.87–1.13) for patient survival and 1.03 (95% CI: 0.94–1.14) for graft survival. Unadjusted risk of death-censored graft failure was similar, but after adjustment, it was higher for LUD transplants (1.19; 95% CI: 1.04–1.35). In conclusion, patient and graft survival of LRD and LUD kidney transplant recipients was similar, whereas death-censored graft failure was higher in LUD. These findings confirm the importance of both living kidney donor types.

KW - Adult

KW - Edetic Acid

KW - Graft Rejection

KW - Graft Survival

KW - Humans

KW - Kidney Transplantation

KW - Living Donors

KW - Registries

KW - Retrospective Studies

KW - donor source

KW - graft survival

KW - kidney transplantation

KW - living donation

KW - patient survival

UR - https://www.scopus.com/pages/publications/85093691449

U2 - 10.1111/tri.13759

DO - 10.1111/tri.13759

M3 - Article

C2 - 33022814

SN - 0934-0874

VL - 34

SP - 76

EP - 86

JO - Transplant international

JF - Transplant international

IS - 1

ER -

The association of living donor source with patient and graft survival among kidney transplant recipients in the ERA-EDTA Registry – a retrospective study

Abstract

Bibliographical note

Other keywords

Access to Document

Fingerprint

Cite this