SAT-315 Kidney Transplant Recipient Outcomes Using Older Living Donors With Hypertension

Abstract

Although the data supporting long-term safety of nephrectomy in hypertensive donors has been reported, there is scarcity of long term data on the recipient outcomes of such donors. Furthermore the use of older (>60 year) hypertensive donors is even further rare and minimal data exists on the transplant recipient outcomes for these donors. Hence the purpose of our study was to study the demographics of older living donors and their recipient outcomes in the United States. The United States UNOS database was retrospectively reviewed for the purposes of our study for the period January 2000 through Decemeber 2016. We excluded pediatric and multi-organ transplant recipients and limited the time period to minimum one year follow up. Out of 111,483 Living Donors during the study period, we identified 5,695 (5.1%) Living Donor Transplants with a donor age => 60 years that met our criteria.Tabled 1Living Donor Demographics (age> 60)n=5,695Mean Age (yrs)63.4+/-3.2 (Range 60-84)Age 60-64 / >=65+ (%)30.0 / 70.0Race (C/AA/Others) %86/4.2/9.8Gender (M/F) %36.5 / 63.5Donor Blood Type O / A / B / AB %62.3 / 29.3 / 7.4 / 1.0Nephrectomy (Left vs Right) %85.4 / 14.6Donor with h/o HTN (%)9.3Donor Age 65+ and HTN (%)3.2Mean Donor BMI26.6+/-3.9Mean Donor Pre-Donation Creatinine (mg/dl)0.82+/-0.3 Open table in a new tab Tabled 1Recipient Characteristics and OutcomesOverall (n=5,695)Age 60+ HTN Living Donor (n=531)Age 60+ non-HTN Living Donor (n=5,164)Recipient Mean Age (yrs)56.5+/- 12.956.8+/-13.256.5+/-12.9Recipient Race (C/AA/Other) %81.6 / 6.2 / 12.283.6 / 4.3 / 1281.4 /6.4 / 12.2Recipient Gender (M / F)61.9 / 38.163.7 / 36.361.8 / 38.2Mean BMI27.5+/-5.327.7+/-5.427.5+/-5.3Median Waiting Time (days)213201213On Dialysis (%)62.161.862.1Re-Transplants (%)8.38.98.3Delayed Graft Function (%)4.84.74.8Acute Rejection Within 1 yr (%)9.08.99.0Death with Functioning Kidney Graft (%)16.09.616.6* Open table in a new tab There was no difference in all-cause unadjusted graft survival between recipients with Older HTN vs non-HTN donors (p=0.57), or death censored graft survival (p=0.79) or patient survival (p-0.52). Similarly there was no difference in graft survival between these two groups for race, gender, on dialysis, DGF, acute rejection. In the HTN Living Donor Group, there was no difference in graft survival between recipient races, genders, donor races and acute rejection. Graft Survival was inferior in all donors > 65 (p=0.0005), as well as HTN vs non-HTN donors (p=0.035) as compared to donors age 60-64 years.Tabled 1Age60+ HTN Living Donors (n=531)Age60+ Non-HTN Living Donors (n=5,164)Graft SurvivalAll Cause GS / DCGS (%)All Cause GS / DCGS 9%)1yr95 / 9895 / 983yr86 / 9588 / 955yr79 / 8978 / 9110yr61 / 8653 / 7915yr24 / 4530 / 60 Open table in a new tab Transplant Recipient outcomes from Older hypertensive living donors are favorable and comparable to those donors without HTN. Careful selection of such donors and matching to appropriate recipients should not be discouraged when such donors are available.