POS-687 DONOR CYSTATIN C eGFR> 100 ml/min/1.73m2 IS AN INDEPENDENT PREDICTOR OF GRAFT SURVIVAL IN INDIAN KIDNEY TRANSPLANT RECIPIENTS

Abstract

India is currently facing an explosion of lifestyle related non-communicable disease, a fact that has major implications for its kidney transplant programme, which is predominantly living kidney donor driven. In this scenario, careful donor selection is required in order to maximise benefit to the recipient and minimise harm to the donor. This study aimed to determine the effect of demographic and metabolic donor characteristics on recipient graft outcome. This single centre, retrospective cohort study included all living donor kidney transplants taking place at a tertiary care centre in southern India from July 2009 – June 2018. Data concerning donor demographic characteristics (age at donation, gender, relationship to the recipient, parity), metabolic risk factors (glycemic status, BMI, non-alcoholic fatty liver disease, dyslipidemia, smoking history, abdominal aortic calcification, hypertension), and kidney function and structure (CKD EPI cystatin C eGFR, CKD EPI creatinine eGFR, presence of cysts or scars in the kidney) were collected from transplant records and the hospital information system and analysed to determine their effect on recipient graft survival A total of 706 living kidney donor transplants took place during the study period. Mean donor age was 43.1 ± 10.8years, 69.1% were female and 62.7% were first degree relations of the recipient. On multivariate Cox proportional hazards analysis, only donor pre-donation CKD EPI cystatin C eGFR> 100 ml/min/1.73 m2 (p = 0.037, HR 0.485, 95% CI 0.246 – 0.957 ), was independently associated with better graft survival, even after adjustment for induction agent, native kidney disease, HLA mismatches, prior sensitization, rejections and symptomatic UTIs. A pre-donation CKD EPI cystatin C eGFR> 100 ml/min/1.73m2 is associated with better graft survival, and may be a useful indicator of adequate donor nephron endowment in South Asian kidney donors which needs to be validated in prospective studies.