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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
The proportion of living-donor kidney transplants in Japan is markedly higher than in other countries. Although living donors’ safety is the highest priority, the incidence of end-stage renal disease requiring dialysis among living kidney donors is reported to be approximately 0.05%, according to the Japanese Society for Dialysis Therapy. While donor selection adheres to national guidelines, the long-term renal outcomes associated with preoperative risk factors remain insufficiently validated. This study aimed to identify preoperative risk factors of post-donation renal prognosis using a nationwide registry of living kidney donors compiled by the Japan Society for Transplantation.
13,095 living kidney donors registered between 2009 and 2022, with preoperative eGFR ≥ 70 mL/min/1.73 m² were analyzed. The observation period was defined as the time from the date of kidney donation to the primary endpoint or the last follow-up date, whichever occurred first. The primary outcome was kidney function decline, defined as an eGFR < 45 mL/min/1.73 m² (CKD stage 3b). The eGFR decline curves were estimated using the Kaplan-Meier method. Multivariable Cox proportional hazard models were applied to identify factors associated with kidney function decline, adjusting for age, sex, body mass index (BMI), smoking history, hypertension, diabetes, and preoperative eGFR. Additional analyses were conducted using alternative endpoints (eGFR < 30; CKD stage 4 and eGFR < 15; CKD stage 5). Absolute risks (hazard functions) for eGFR decline were also estimated using spline functions.
Of the 13,095 donors, 4,643 (35.5%) were male and 8,452 (64.5%) were female. The mean age of donors was 61.4±11.2 years, and the mean preoperative eGFR was 102.2±10.1 mL/min/1.73 m². The median follow-up time was 36 months (IQR: 12–72 months). During follow-up, 523 donors (4.0%) progressed to CKD stage 3b. In univariate Cox proportional hazards analysis, age, sex, higher BMI, smoking history, hypertension, diabetes, and preoperative eGFR were all statistically significant. In multivariable analysis, pre-donation higher BMI (Hazard Ratio (HR) 1.08, 95% CI 1.04–1.11, p < 0.001), pre-donation hypertension (HR 1.25, 95% CI 1.04–1.51, p = 0.02), and preoperative eGFR (HR 0.87, 95% CI 0.85–0.88, p < 0.001) were identified as independent risk factors for kidney function decline (Table 1). Similar trends were observed when using CKD stages 4 and 5 as alternative endpoints. Furthermore, the absolute risk of eGFR < 45 mL/min/1.73 m² demonstrated a bimodal pattern, with an early peak around 3 months and a smaller peak around 25 months after donation, more pronounced with older age.
Pre-donation higher BMI, hypertension, and preoperative eGFR were independent predictors of post-donation kidney function decline in living kidney donors. Our findings suggest that these factors can be utilized for donor selection, and close postoperative monitoring of these donors is warranted to prevent kidney function decline. Multi-institutional studies with extended follow-up are needed to refine donor risk stratification and enhance donor safety in clinical practice.
