|
1
|
Dobrijevic ELK, Au EHK, Rogers NM, Clayton PA, Wong G, Allen RDM. Association Between Side of Living Kidney Donation and Post-Transplant Outcomes. Transpl Int 2022; 35:10117. [PMID: 35444489 PMCID: PMC9013757 DOI: 10.3389/ti.2022.10117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/03/2022] [Indexed: 11/13/2022]
Abstract
Background: Right-sided living donor kidneys have longer renal arteries and shorter veins that make vascular anastomosis more challenging. We sought to determine whether recipients of right-sided living donor kidneys have worse outcomes than left-sided kidney recipients. Methods: An observational analysis of the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) was undertaken. We used adjusted logistic regression to determine the association between side and delayed graft function (DGF) and time-stratified adjusted cox regression models for graft and patient survivals. Results: Between 2004 and 2018, 4,050 living donor kidney transplants were conducted with 696 (17.2%) using right kidneys. With reference to left kidneys, the adjusted OR (95% CI) for DGF was 2.01 (1.31–3.09) for recipients with right kidneys. Within 30 days, 46 allografts (1.4%) were lost, with major causes of overall graft loss being technical, primary non-function and death. Recipients of right donor kidneys experienced a greater risk of early graft loss (aHR 2.02 [95% CI 1.06–3.86], p = 0.03), but not beyond 30 days (aHR 0.97 [95% CI 0.80–1.19], p = 0.8]). Conclusion: Technical challenge is the most common cause of early graft loss. The risk of early graft loss among recipients who received right kidneys is doubled compared to those who received left living donor kidneys.
Collapse
Affiliation(s)
| | - Eric H K Au
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,The Centre for Transplant and Renal Research, Westmead Institute of Medical Research, Westmead, NSW, Australia
| | - Natasha M Rogers
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,The Centre for Transplant and Renal Research, Westmead Institute of Medical Research, Westmead, NSW, Australia.,Department of Renal and Transplant Medicine, Westmead Hospital, Westmead, NSW, Australia.,Starzl Transplant Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Philip A Clayton
- Central and Northern Adelaide Renal and Transplantation Services, Adelaide, SA, Australia.,Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, SA, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Germaine Wong
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,The Centre for Transplant and Renal Research, Westmead Institute of Medical Research, Westmead, NSW, Australia.,Department of Renal and Transplant Medicine, Westmead Hospital, Westmead, NSW, Australia
| | - Richard D M Allen
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.,The Centre for Transplant and Renal Research, Westmead Institute of Medical Research, Westmead, NSW, Australia.,Department of Transplantation Surgery, Westmead Hospital, Westmead, NSW, Australia
| |
Collapse
|