Kidney Week

Abstract: FR-PO824

A Propensity-Score Matched Analysis of Long-Term Outcomes for Living Kidney Donation in Alternative Complement Pathway Diseases

Session Information

• Transplantation: Clinical - Outcomes
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Caliskan, Yasar, Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Yasar Caliskan,

• Safak, Seda, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Seda Safak,

• Oto, Ozgur Akin, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Ozgur Akin Oto,

• Velioglu, Arzu, Marmara Universitesi, Istanbul, Istanbul, Turkey

Arzu Velioglu,

• Yelken, Berna, Koc Universitesi, Istanbul, Istanbul, Turkey

Berna Yelken,

• Dirim, Ahmet Burak, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Ahmet Burak Dirim,

• Yildiz, Abdulmecit, Bursa Uludag Universitesi, Bursa, Turkey

Abdulmecit Yildiz,

• Mirioglu, Safak, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Safak Mirioglu,

• Guller, Nurana, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Nurana Guller,

• Yazici, Halil, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Halil Yazici,

• Ersoy, Alparslan, Bursa Uludag Universitesi, Bursa, Turkey

Alparslan Ersoy,

• Turkmen, Aydin, Istanbul Universitesi Istanbul Tip Fakultesi, Istanbul, Istanbul, Turkey

Aydin Turkmen,

• Lentine, Krista L., Saint Louis University School of Medicine, Saint Louis, Missouri, United States

Krista L. Lentine,

Background

We examined the clinical course of living donors (LDs) to recipients with atypical hemolytic-uremic syndrome (aHUS) and C3 glomerulopathy (C3G) and compared their outcomes with a control group to improve understanding of the clinical course and outcomes of living donation in this context.

Methods

The cohort of LDs of aHUS/C3G recipients (Complement-LD group) and propensity score-matched control LDs without any family history of aHUS/C3G (Control-LD group) were retrospectively identified from data at 4 transplant centers (2003-2021). LD were followed for major cardiac events (MACE), de novo hypertension, cancer, death, post-donation eGFR and proteinuria.

Results

The cohort comprised 24 LD to recipients with aHUS (46%) and C3G (54%) including 18 related LDs. Long-term outcomes were compared with propensity score-matched control group over 5 years (IQR,3-11.8) follow-up. During follow-up, none of the LDs in complement-LD group developed MACE whereas two LDs in control-LD group developed MACE (18.5%) after 8 (IQR,2.6-12.8) years (p=0.15). New-onset hypertension was similar between groups (20.8% vs 25%, p=0.73) (Table 1). There were no differences between study groups regarding last eGFR and proteinuria levels (p=0.11 and p=0.40, respectively). None of the donors developed kidney failure (eGFR<15ml/min/1.73m² or dialysis). In complement-LD group a related donor developed gastric cancer and another related donor developed a brain tumor and died at 4^th year after donation (Table 1).

Conclusion

The risks of kidney failure, cardiovascular disease, de novo aHUS and C3G in carefully selected LD to recipients with aHUS and C3G appear to be low. Cancer development in related LDs of recipients with complement mediated disease may need further investigation.