The Results of Spousal Donor Kidney Transplantation Via Exchange Donor Program and Direct Spousal Donor Kidney Transplantation in Living Donor Kidney Transplantation: Single Center Experience

Abstract

Background: The shortage of living related and deceased donor groups is one of the major problems of kidney transplantation. We examined the results of spouse and spousal exchange among living kidney transplantation. Methods: Living donor kidney transplants at a single center between 1991 and 2005 were studied, retrospectively (n=593). We compared the graft survival rates of 24 spousal, 53 spousal exchange transplantations with those of 125 sibling, 142 other living related donor (LRD) or 249 other living unrelated donor (LURD) procedures. We analyzed graft survival rate, acute rejection rate among each groups. Results: The 5, 10 year graft survival rates of spousal donor were 75.0%, 69.2%, those of other LURD and spousal exchange were 74.6%, 64.5% (P=0.80) and 86.6%, 84.8% (P=0.11), those of sibling and other LRD were 82.3%, 75.9% (P=0.37) and 75.7%, 65.4% (P=0.84). Spousal exchange donor were more good graft survival rates rather than other LRD and LURD (P=0.01, 0.01). Acute rejection rates of spousal donor were not significant difference among sibling, other LRD and LURD groups. But acute rejection rates of spousal exchange donor (22.6%) were lower than spousal (45.8%) and other LURD (38.7%) (P=0.04, 0.04). In the multivariate analysis of donor groups, other LRD and LURD groups were associated with a high relative odds of graft survival (odds ratio 2.88±0.38 (P=0.02), 2.35±0.37 (P=0.01)) compared to spousal exchange donor groups. Conclusions: The spousal exchange donors had more good graft survival rates than other LRD and LURD groups and spousal donors were as good as other living donors. We expect that the spousal and spousal exchange transplantations are one of the good programs for donor pool expansion.