A comparative study of recipients' outcomes receiving a kidney from the same deceased donor: An observational study

Abstract

Introduction: Kidney transplantation is the renal replacement therapy (RRT) of choice for patients with end-stage renal disease. Although outcomes of deceased-donor kidney transplantation are inferior when compared to live donor kidney transplantation, they are still significantly better than being on chronic dialysis. There are very few studies comparing transplant outcomes between two kidneys obtained from the same donor. Aims: The aim of this study is to compare the graft and patient outcome of the kidneys of the same deceased donor transplanted into two different recipients. Materials and Methods: This is a prospective observational study done at the tertiary care center in South India over 2 years. A total of 29 pairs of deceased-donor transplants were followed up with one-half performed at donor institute (Group 1) and the same number performed at another network hospital (Group 2). Outcomes between the recipients of the two kidneys were compared. Data were statistically analyzed. Results: The majority of donors were relatively young (with a mean age of 37 years) and did not have multiple comorbidities. 1st kidney went to the donor hospital, whereas 2nd kidney was sent to other hospitals in the network. Cold ischemia times were higher (10.3 h vs. 6.5 h) for the 2nd kidneys. The majority of Group 1 patients did not receive induction, whereas 100% of Group 2 patients received basiliximab induction. The incidence of acute rejection (antibody plus cellular rejection) was numerically less in Group 2 compared to Group 1 but was not found to be statistically significant (P = 0.227). The incidence of acute cellular rejection in Group 1 was more compared to Group 2, and was found to be statistically significant (P = −0.038). Graft survival was similar in both groups (95.7 in Group 1 vs. 95.8 in Group 2). Patient survival was similar in both groups (P = −0.555) with a mean follow-up 25.9 months in Group 1 versus 24.6 months in Group 2. The choice of induction agent did not affect the graft or patient survival. In addition, there was no significant difference in the incidence of infections or mortality rate. Conclusion: Overall, the outcomes in the paired kidneys from the same donor transplanted to different recipients at different institutes had similar outcomes. The choice of induction agent did not have any influence on the overall graft and patient survival.