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- W4239897269 abstract "431 Given the severe organ shortage and the documented superior results with living vs. cadaver donor kidney transplants, we have adopted a very aggressive policy for the use of living donors. Currently, we make thorough attempts to locate a living related (LRD) or living unrelated (LURD) donor before proceeding with a cadaver transplant. We compared the results of our LURD vs. LRD transplants to determine if there was any significant difference in outcome. Between 1/1/84 and 6/30/98, 711 adult kidney transplants with non-HLA identical living donors were performed. Of these, 595 were with LRDs and 116 with LURDs. Immunosuppression for both groups was cyclosporine-based, though LURD recipients received 5 to 7 days of induction therapy (ALG or ATG) while LRD recipients did not. Demographic characteristics are shown in the table. LURD recipients tended to be older, to have inferior matching, and to have older donors vs. LRD (all factors potentially associated with decreased graft survival). Short-term results, including initial graft function and incidence of acute rejection, were no different between the two groups. LURD recipients had a slightly higher incidence of CMV disease (p=ns). We found no difference in patient and graft survival rates. However, the incidence of biopsy-proven chronic rejection (CR) was significantly lower in LURD recipients (p=0.05) (graph). The exact reason for this is unknown; one possibility is that LURD recipients may have better compliance rates vs. LRD recipients (12 of the 595 LRD grafts have been lost after recipients discontinued immunosuppression vs. 2 of LURD grafts). (Figure)TableFigureConclusion: Although LURD transplants have poorer matching and older donor age, patient and graft survival rates are equivalent to non-HLA identical LRD transplants. The incidence of biopsy-proven CR is lower in LURD transplants. Given this finding and the superior results of living donor vs. cadaver transplants, a thorough search should be made for a living donor (LRD or LURD) before placing a potential recipient on the cadaver waiting list." @default.
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- W4239897269 date "1999-05-01" @default.
- W4239897269 modified "2023-09-26" @default.
- W4239897269 title "LIVING UNRELATED DONORS IN KIDNEY TRANSPLANTS: BETTER LONG-TERM RESULTS THAN NON-HLA IDENTICAL LIVING RELATED DONORS?" @default.
- W4239897269 doi "https://doi.org/10.1097/00007890-199905150-00454" @default.
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