O041 Recipient outcomes after simultaneous pancreas and kidney transplant delineated by donor EGFR

Abstract

Introduction This study aimed to assess if the use of kidneys from donors with a decreased eGFR had an adverse effect on patient and graft survival. Methods Data on all UK SPKT's from 2001-2021 were obtained from the NHSBT UK Transplant Registry (n=2,631). Cases with missing information were removed, leaving a final cohort of 1,819 (69.1%). eGFR was calculated using the CKD-EPI equation. Pancreas Graft (PGS), Kidney Graft (KGS) and patient survival analyses were conducted using Kaplan-Meier plots and Cox-regression models. Results 71% (n=1,292) of grafts were from donors with an eGFR>90 and 29%(n=530) were from donors with an eGFR<90. Donors with an eGFR<90 were statistically significantly more likely to be older (p<0.0001), a DBD donor (p=0.0086**) and have a higher BMI(p<0.0001). Recipients who received a graft from a donor with an eGFR<90 were well matched with those who received a graft from a donor with an eGFR>90. Univariate analysis showed a statistically significant decreased KGS(p=0.007**) when the donor had an eGFR<90. This trend was not seen when comparing patient or pancreas survival. Conclusion We accept a lower GFR could be indicative of either an AKI or a sign of early chronic kidney disease. In this current data analysis, we have been unable to successfully distinguish between the two however we have shown poorer KGS in those with a lower eGFR (<90). This had no impact on pancreas or patient survival. Further analysis is needed to explain the precise reasons for the lower eGFRs at the time of organ donation.