Outcomes of kidney donors with sickle cell trait: A preliminary analysis

Abstract

Most transplant centers do not screen kidney donor candidates for sickle cell trait (SCT) and many decline candidates with SCT since it may associate with kidney disease.We compared 17 kidney donors with SCT to propensity score matched donor controls on mortality, reduced eGFR, proteinuria and kidney failure. The prevalence of SCT in African American (AA) donors was 11 per 1000 compared to 73 per 1000 in non-donor AA. Donors with SCT were younger; 33 versus 35 years in controls, nine were AA, six were White, and two were listed as other or unknown ethnicities. After a follow-up period of 18.2 ± 10.5 years, the proportions of donors with SCT and controls who were alive, developed hypertension or cardiovascular disease were similar. No donor with SCT developed an eGFR <30 mL/min/1.73 m 2 or kidney failure. SCT was, however, associated with increased risk of proteinuria; RR 5.71 (95% CI 5.7 -22.7), P = .01. This small and preliminary case series suggest that donors with SCT should perhaps be considered more often provided they were aware of the lack of evidence to support liberal acceptance and that these outcomes reported here likely represent a healthy cohort of donors with SCT.

Management of the Sickle Cell Trait: An Opinion by Expert Panel Members

“…Given the shortage of data reported in the literature on kidney transplantation from living donors with SCT, it is difficult to evaluate additional risks compared to the normal population, even though no serious adverse events have been reported [117]. The kidney function of potential donors must still undergo a careful assessment before and after nephrectomy and, during nephrectomy, the instructions for major surgeries must be followed.…”