Comparison of Glomerular Filtration Rate in Transplanted Kidneys between Living and Deceased Donors after 12 Months of Transplantation

Abstract

ABSTRACT

Background: Kidney transplantation (KT) is the treatment of choice for end stage renal disease (ESRD) supplied from living donors or deceased ones.

Objective: This study aims to assess trends in renal function, as measured by glomerular filtration rate (GFR), in living and deceased donor groups within 1 year post-transplant surgery.

Methods: We included ESRD patients admitted to the Hasheminejad Kidney Center in Iran from 2001 to 2014. GFR was the primary outcome of interest.

Results: Among a total of 442 recipients, 382 individuals were included in the GFR study population. Over three-quarters of the study sample (n= 291; 76.4%) received a transplant from a living donor. The average baseline GFR (SD) among patients with deceased and living donors was 55.5 (26.75) and 63.8 (22.45), respectively. The interaction of time and donor type was used to evaluate the trend of GFR per 6 months, and it was 1.37 (mL/min) higher in the living donor group (95% CI= -0.88-3.62 and p= 0.234). Out of 415 recipients with recorded rejection status, 142 (34.2%) had acute rejection, more often in deceased-donor than living-donor recipients (42.9% vs 31.5%, p= 0.039). However, in multivariable analysis, donor type was not independently associated with rejection (OR= 0.76, 95% CI= 0.45–1.27; p= 0.29), while lower baseline GFR and delayed graft function were associated with higher odds.

Conclusion: The annual decrease in GFR was identical across the study groups, although the absolute GFR level was higher in patients with living donors.

KEYWORDS: Kidney transplantation; Glomerular filtration rate; Deceased donor; Living donor; Rejection rate