10-Year Graft Survival Similar with Living Related, Unrelated Donors

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DENVER—Kidney transplants involving living related and unrelated donors have similar 10-year graft survival, even with differences in HLA matching, according to Brazilian investigators.

The researchers, Igor Marques, MD, and colleagues at the University of Sao Paulo School of Medicine, analyzed data from 389 first living-donor kidney transplant recipients: 281 who received kidneys from a living related donor (LRD) and 108 who received kidneys from a living unrelated donors (LURD). In the LRD group, 50 patients (17.8%) were HLA-identical siblings, 181 (64.4%) had a parent donor with hapoidentical HLA and the remaining 50 patients (17.8%) had a distinct HLA-matching. The LURD patients differed from the LRD group in age, gender, and HLA-matching. The patients who recdeived a kidney from a relative were younger at the time of transplantation. Female subjects represented more than half of the patients in the LRD group, whereas in the LURD group, they represented about a third. As the researchers expected, the LRD group had poor HLA-matching.

The incidence of acute rejection was similar in both groups (25% in the LRD group and 26% in the LURD group), the researchers reported. They observed no significant difference in patient survival when analyzed from the time of transplantation. The one-year patient survival rate in the LUD and LRD groups was 96% and 95.3%, respectively. The five- and 10-year survival rates were 91.6% and 92.4%, respectively, and 89.1% and 84.7%, respectively.

The death-censored graft survival rates for LUD transplants were 94.8%, 91.7%, and 68.9% at three, five, and 10 years, respectively, which is comparable to the rates for LRD transplants (excluding HLA-identical siblings), which were 92.5%, 88.9%, and 81.1%, respectively.
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