Comparison of outcomes of living and deceased donor kidney grafts surviving longer than 5 years in Korea

Abstract

Background: It is generally recognized that living donor kidney transplantation (LDKT) grafts are superior to deceased donor kidney transplantation (DDKT) grafts. We compared survival and functional outcomes of LDKT and DDKT grafts.

Methods: Among 1000 kidneys transplanted from 1995 to 2008, we selected grafts surviving >5 years, excluding pediatric, multi-organ transplantation, and retransplantations (n=454).

Results: There were 179 kidneys from deceased donors and 275 from living donors. Recipients showed no difference in age, gender, or cause of renal failure. Donors were younger in the DDKT group (30.6 vs 38.5 years; P<.05). There were more male donors in the DDKT group (73.2% vs 54.5%; P<.05). Deceased donors showed a greater mean number of HLA mismatches (4.2 vs 2.7; P<.05). Death-censored graft survival at 10 years showed no difference (DDKT 88.9% vs LDKT 88.9%; P=.99). Mean serum creatinine at 5 years was 1.41 mg/dL for DDKT and 1.44 mg/dL for LDKT (P=.75). Mean estimated glomerular filtration rate at 5 years was 67.8 mL/min/1.73 m2 for DDKT and 62.1 mL/min/1.73 m2 for LDKT (P=.23). Twenty-three DDKT grafts (12.8%) and 47 LDKT grafts (17.1%) experienced acute rejection episodes (P=.22). DDKT recipients showed more cases of viral and bacterial infections compared with LDKT recipients (viral, 11.7% vs 2.2% [P<.05]; bacterial, 21.8% vs 7.3% [P<.05]).

Conclusion: Among kidney grafts surviving >5 years, there was no difference in survival or serum creatinine levels at 5 and 10 years between DDKT and LDKT grafts.