Comparison of Long-Term Outcomes between Spousal Transplants and Other Living Unrelated Donor Transplants: Single-Center Experience

Yoon, Hye Eun; Song, Joon Chang; Hyoung, Bok Jin; Hwang, Hyeon Seok; Lee, So Young; Jeon, Yeon Jin; Park, Sun Cheol; Choi, Bum Soon; Kim, Yong Soo; Moon, In Sung; Yang, Chul Woo

doi:10.1159/000235248

Cited by 8 publications

(9 citation statements)

References 35 publications

(26 reference statements)

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“…This is in contrast to previously published studies, where the incidence of an acute allograft rejection has been found to be slightly more in SD transplants as compared to RD transplant[124791013151619] although the difference has been found to be statistically significant in only one study. [10] One study[8] has found that recipients of SD transplants are significantly more likely to have early acute allograft rejection as well as more severe rejection.…”

Section: Discussioncontrasting

confidence: 99%

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Outcomes of spousal versus related donor kidney transplants: A comparative study

Mittal¹,

Ramachandran²,

Kumar³

et al. 2014

Indian J Nephrol

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This study was designed to compare the outcomes of spousal donor (SD) with related donor (RD) kidney transplants performed at our center between January 2010 and October 2012. A total of 323 adult, ABO-compatible kidney transplants (SD 150 [46.4%], RD 173 [53.6%]) were included. Data on outcomes at 6 months post-transplant was collected retrospectively (2010-2011) and prospectively (January-October 2012). Majority of the donors (SD 88%, RD 72.2%) were females. In the SD group, donors were younger (SD 35.6 ± 8.2 years, RD 45.2 ± 11.5 years; P < 0.0001), whereas recipients were older (SD 42.2 ± 8.3 years, RD 30.0 ± 9.5 years; P < 0.0001). A significantly higher proportion of patients in the SD group were given induction therapy (43% vs 12%; P < 0.001). Biopsy proven acute rejections were more common in the RD group (16% vs 28.3%; P = 0.01). Majority (80.8%) of the acute rejections occurred in the first 2 weeks post-transplant in both groups. Isolated acute cellular rejections (ACRs) and isolated antibody mediated rejections constituted 50% and 25% of rejection episodes in both groups, whereas the remainder had histological evidence of both. The proportion of steroid responsive ACRs was similar in both groups (SD 83.3%, RD 65.4%; P = 0.2). The number of patients with abnormal graft function at the end of the study was higher in the RD group (2.3% vs. 12.3%; P = 0.001). Patient survival and infection rates were similar in the two groups. We conclude that short-term outcomes of SD transplants are not inferior to RD transplants. Lesser use of induction therapy in the RD group may explain the poorer outcomes as compared to the SD group.

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Section: Discussioncontrasting

confidence: 99%

“…Similarly, another study[1] has reported graft function in SD transplant recipients to be significantly inferior at the end of the follow-up period when compared to RD transplant group. In other studies[2478911151619] however, graft function was similar in the two groups. Possible reasons for the contrasting results are:…”

Section: Discussionmentioning

confidence: 57%

Outcomes of spousal versus related donor kidney transplants: A comparative study

Mittal¹,

Ramachandran²,

Kumar³

et al. 2014

Indian J Nephrol

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“…First, spouse donors are not limited by legal and ethical problems. Second, the graft outcome from a spouse donor is as good as from an LRD [9,10] or other LUDs [11]. Third, in a nuclear family system, it is natural to prefer one's spouse as an organ source to other familial members.…”

Section: Discussionmentioning

confidence: 99%

Changing Donor Source Pattern for Kidney Transplantation over 40 Years: A Single-Center Experience

Chung

Jung

Bae

et al. 2010

Korean J Intern Med

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Background/AimsKidney transplantations at our center rely mainly on living donors. The purpose of this study was to suggest future donor supply directions by reviewing changing trends in donor type.MethodsDuring the past 40 years, 1,690 kidney transplantations were performed at our center. We divided the follow-up period into four decades and the donor population into three groups: living related, living unrelated, and deceased. We analyzed changing trends in donors from each group for each decade. Patients receiving overseas transplantation were also included.ResultsThe proportion of living related donors decreased from 84% (54/64) in the 1970s to 61% (281/458) in the 2000s. Living unrelated donors showed a sustained proportion of around 20% after 1990. However, among living unrelated donors, the proportion of spouse donors increased from 4.6% (17/369) in the 1980s to 8.5% (39/458) in the 2000s. Transplants from deceased donors were only 3.3% (12/369) in the 1980s. However the proportion of deceased donors increased gradually, reaching 13.2% (105/799) in the 1990s and 19.9% (91/458) after 2000. Overseas transplantations increased after 2000 and reached 20% of all cases treated in our center during the 2000s. Such transplantations peaked in 2006 and decreased markedly thereafter.ConclusionsThe proportion of each donor type has continuously changed, and the changes were associated with changes in the social structure and system. We expect that this study could be an important reference for other countries to estimate future changes of donor type.

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“…With the development of more effective immunosuppressive medication and an expanding experience regarding AB0-incompatible transplantation, also genetically unrelated living donors are able to donate a kidney ( 6 , 7 ). In Germany, a close relationship between donor and recipient is mandatory.…”

Section: Introductionmentioning

confidence: 99%

“…Altruistic or anonymous donation is legally not allowed. Spouses, which seem to be as suitable as other genetically unrelated living donors ( 7 , 8 ), represent a large group of organ donors. Due to their close relationship to the recipient, often living in the same household, they experience the consequences of ESRD first hand.…”

Section: Introductionmentioning

confidence: 99%

Partnership Satisfaction in Living Kidney Donors

et al. 2018

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Due to organ shortage, living kidney donation is gaining increasing importance. Medical progress enables a successful transplantation between unrelated individuals, even individuals with AB0-incompatibilities. Spouses are the largest group of living kidney donors. The aim of this study was to assess partnership status and partnership satisfaction in living kidney donors. In the cross-sectional study we investigated 361 living kidney donors. The time since donation ranged between 1 and 38 years. The partnership satisfaction was assessed with the German version of the Quality of Marriage Index. We compared the donor sample with a representative German population sample (n = 1995). In addition, we compared donors who have donated to their partner (spouse donors) to those who have donated to someone else (non-spouse donors). In comparison to the population sample significantly more kidney donors were living in a relationship (82 vs. 60%). Most donors reported an unchanged (76.6%) or improved (20.5%) relationship to the recipient since transplantation. A significantly higher partnership satisfaction could be found in the donor sample compared to the population sample which was mainly due to a higher partnership satisfaction of the spouse donors compared to the non-spouse donors. High partnership satisfaction in living kidney donors might be an indicator for a successful selection process before transplantation. Alternatively, kidney donation might have a stabilizing or even positive impact on the partnership. Due to the design of our study causative interpretations cannot be made. Therefore, prospective studies are required to assess partnership satisfaction before and after living kidney donation.

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Comparison of Long-Term Outcomes between Spousal Transplants and Other Living Unrelated Donor Transplants: Single-Center Experience

Cited by 8 publications

References 35 publications

Outcomes of spousal versus related donor kidney transplants: A comparative study

Outcomes of spousal versus related donor kidney transplants: A comparative study

Changing Donor Source Pattern for Kidney Transplantation over 40 Years: A Single-Center Experience

Partnership Satisfaction in Living Kidney Donors

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