241 Association Between Lower Graft Survival and Kidneys from Donors Aged 40-49 Years with Co-Morbidities

Abstract

ASSOCIATION BETWEEN LOWER GRAFT SURVIVAL AND KIDNEYS FROM DONORS AGED 40-49 YEARS WITH CO-MORBIDITIES Anita Patel, Mohamad Al-Abed, Mariella Goggins, Lauren Malinzak, Vanji Karthikeyan, Department of Internal Medicine and Transplant Institute, Henry Ford Hospital, Detroit, MI, United States Several recipient (R) and donor (D) risk factors are associated with inferior graft survival (GS). Outcomes of recipients (R) receiving kidneys from standard criteria donors (SCD) aged 40-49 years with risk factors of ECD criteria coined compromised SCD donors (CSCD) were compared with SCDR using UNOS data from1995 to 2010. Patient survival (PS) and GS were studied. Median follow up was 4 years. On Kaplan Meier survival analysis, both PS and GS appeared to be significantly superior for SCDR compared to CSCDR. However, on Cox regression analysis, there appeared to be a marginally significant decrease in PS (Hazard ratio [HR] 1.089 [95% confidence interval 1.010-1.174]); p=0.02) in CSCDR. In this group, GS was significantly lower (HR:1.109 [CI 1.031-1.192]; p=0.0053). However, patient survival was not significantly different. In conclusion, GS appears to be strongly influenced by donor risk factors in age group 40-49 years. It is possible that duration and severity of co-morbidities and effective renal reserve influence graft outcomes in this age group of standard criteria donors. Whether the same influence exists in donors less than 40 years of age or healthy donors over age 50 years is being invested. Influence of other risk factors including components of the metabolic syndrome is also being studied.