Introduction:
Kidney transplantation offers better survival and quality of life and is more cost-effective than dialysis treatment for patients with kidney failure. Living Donor Kidney Transplantation (LDKT) accounts for more than 80% of Kidney Transplantation (KT) in India. However, Deceased Donor Kidney Transplantation (DDKT) comprises 30% of KTs at our centre. In-house organ procurement ensures short cold ischaemia time (CIT) and reduces risk for Delayed graft function (DGF). We compared the graft and patient outcomes of LDKT with DDKT at our centre
Methods:
Data on Baseline characteristics, posttransplant complications, and patient and graft outcomes of living donor and deceased donor kidney transplant recipients between March 2012 and February 2023 were extracted from a prospectively maintained database in the Department of Nephrology
Results:
Out of 266 kidney transplantation (KT) operations performed during the study period, 172 were LDKT and 94 DDKT. 34% of DDKT recipients were women, and only 20% of LDKT recipients were women. CIT was significantly longer for DDKT 180 mins (IQR 150, 240) compared to LDKT 89 mins (IQR 67,115). Most (95.74%) DDKT received Thymoglobulin induction, whereas only 68% of LDKT received an induction agent, 2/3rd of which was Basiliximab. Deceased Donors were significantly younger (DD 36.27 years Vs LD 43.97 years, p < 0.001) and were predominantly male (73.4 male DDs Vs 19.2% male LDs). Incidence of biopsy-proven acute antibody-mediated rejection (ABMR) was higher in LDKT compared to DDKT (14.53% Vs 6.38%, p = 0.048). There was no difference in the incidence of DGF after LDKT and DDKT. 101 patients experienced either graft loss or death with a functioning graft, and 27.4% of all patients had died (including death with a functioning graft as well as death later after graft loss)
Conclusions:
Death-censored graft survival after DDKT was better than LDKT. The younger age of deceased donors, along with thyroglobulin induction, low incidence of DGF and lower frequency of ABMR in DDKT recipients, possibly accounts for the poorer death-censored graft survival after LDKT
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.