UNRELATED LIVING KIDNEY DONOR TRANSPLANTATION IN A SINGLE UK CENTRE

Abstract

P140 Aims: The aim of this study is to compare the outcome of living kidney donor (LKD) transplants between unrelated individuals and related individuals in a single UK centre. Methods: All patients receiving LKD transplants from 1993 to November 2003 are included. Patient records were used to retrieve demographics, graft function and rejection rates. Data was obtained for analysis of graft and rejection-free survival (length of time from transplantation to the first histological diagnosis of any grade of rejection). Results: 126 LKD transplants were performed, of which 31 were between genetically unrelated donors and recipients. 20.7 months (IQR 6.8-51.5). Median follow-up was Recipients were significantly older in the unrelated group older (p<0.001 Mann-Whitney). The total mismatches for the unrelated group (median 4, IQR 3-5) was significantly greater (p<0.001 Mann-Whitney) than the related group (median 2, IQR1-3). By life table analysis the overall actual 1 and 5 year graft survival was 96.0% (SE±1.7) and 90.9% (SE±4.0). There was no difference in graft survival between the unrelated LKD and related LKD transplants (Log rank p=0.391). Rejection free survival was 58.6% at 30 days overall, with no statistical difference between the related (59.1%) and unrelated (53.5%) groups (Log rank p=0.726). Conclusions: LKD transplantation between unrelated individuals has as good outcomes as transplantation between related individuals. The only barriers to live donation are now positive cross-match and blood group incompatibility. The irrelevance of MHC mismatching suggests that in such situations the concept of ’paired exchange’ is a viable way of addressing the transplant waiting list.