PMID- 36397892
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221119
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 10
DP  - 2022 Oct
TI  - Biologically Unrelated Living Donor for Kidney Transplantation Associated With 
      Higher Acute Rejection Rate but With Similar Graft Survival of a Related Living 
      Donor.
PG  - e30189
LID - 10.7759/cureus.30189 [doi]
LID - e30189
AB  - INTRODUCTION: Kidney transplantation (KT) from living donors has been shown to 
      have multiple benefits compared to those from deceased donors. We sought to 
      compare significant graft outcomes, namely acute rejection (AR), graft function, 
      and survival between transplant recipients who received a kidney from living 
      related donor (LRD) and living unrelated donor (LURD). METHODS: Our cohort 
      comprised 198 donor and recipient pairs undergoing living-donor KT at our center 
      over 10 years. The LRD recipients were compared with LURD recipients according to 
      demographic and clinical characteristics, transplant variables (including 
      immunosuppression), graft function, survival, and AR rate. RESULTS: The estimated 
      glomerular filtration rate (eGFR) was similar in both groups over the follow-up 
      time i.e., 60-65 mL/min (p>0.05 over 10 years). Censored graft survival was 
      similar between LRD and LURD recipients (96.9% vs. 98.0% at five years and 87.8% 
      vs. 79.4% at 10 years, respectively; p=0.837). The LURD recipients had a higher 
      incidence of AR, although LURD recipient status was not an independent risk 
      factor for AR. Multivariate analysis showed that human leukocyte antigen (HLA)-DR 
      mismatch (MM) was an independent predictor of AR (hazard ratio (HR) 2.256, 
      p<0.05). Both HLA-A and HLA-B MM did not affect the AR HR between the groups. 
      CONCLUSION:  Graft function and censored graft survival rates were similar 
      between LURD and LRD KT recipients in our study. The AR was higher in LURD 
      recipients, although the LURD recipient status was not an independent risk factor 
      for AR. The HLA-DR MM was an independent predictor of AR, while HLA-A and HLA-B 
      MM did not affect AR HR between groups of patients.
CI  - Copyright (c) 2022, Reis Pereira et al.
FAU - Reis Pereira, Pedro
AU  - Reis Pereira P
AD  - Nephrology, Centro Hospitalar de Tras-os-Montes e Alto Douro, Vila Real, PRT.
AD  - Nephrology, Dialysis, and Transplantation, Unit for Multidisciplinary Research in 
      Biomedicine - Instituto de Ciencias Biomedicas Abel Salazar (ICBAS), Porto, PRT.
AD  - Integrative and Translational Research, ITR - Laboratory for Integrative and 
      Translational Research in Population Health, Porto, PRT.
FAU - Almeida, Manuela
AU  - Almeida M
AD  - Nephrology, Centro Hospitalar Universitario Porto, Porto, PRT.
AD  - Nephrology, Dialysis, and Transplantation, Unit for Multidisciplinary Research in 
      Biomedicine - Instituto de Ciencias Biomedicas Abel Salazar (ICBAS), Porto, PRT.
AD  - Integrative and Translational Research, ITR - Laboratory for Integrative and 
      Translational Research in Population Health, Porto, PRT.
FAU - Ribeiro, Barbara
AU  - Ribeiro B
AD  - Nephrology, Hospital de Braga, Braga, PRT.
FAU - Oliveira, Joao
AU  - Oliveira J
AD  - Nephrology, Centro Hospitalar Universitario do Porto, Porto, PRT.
FAU - Costa, Luisa
AU  - Costa L
AD  - Nephrology, Centro Hospitalar Tondela-Viseu, Viseu, PRT.
FAU - Pedroso, Sofia
AU  - Pedroso S
AD  - Nephrology, Centro Hospitalar Universitario do Porto, Porto, PRT.
FAU - Martins, La Salete
AU  - Martins S
AD  - Nephrology, Centro Hospitalar Universitario do Porto, Porto, PRT.
AD  - Nephrology, Dialysis, and Transplantation, Unit for Multidisciplinary Research in 
      Biomedicine - Instituto de Ciencias Biomedicas Abel Salazar (ICBAS), Porto, PRT.
AD  - Integrative and Translational Research, ITR - Laboratory for Integrative and 
      Translational Research in Population Health, Porto, PRT.
FAU - Dias, Leonidio
AU  - Dias L
AD  - Nephrology, Centro Hospitalar Universitario do Porto, Porto, PRT.
FAU - Malheiro, Jorge
AU  - Malheiro J
AD  - Nephrology, Centro Hospitalar Universitario do Porto, Porto, PRT.
AD  - Nephrology, Dialysis, and Transplantation, Unit for Multidisciplinary Research in 
      Biomedicine - Instituto de Ciencias Biomedicas Abel Salazar (ICBAS), Porto, PRT.
AD  - Integrative and Translational Research, ITR - Laboratory for Integrative and 
      Translational Research in Population Health, Porto, PRT.
LA  - eng
PT  - Journal Article
DEP - 20221011
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9648680
OTO - NOTNLM
OT  - acute rejection
OT  - graft survival
OT  - immunosuppression
OT  - kidney transplant
OT  - living-related donor
OT  - living-unrelated donor
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/11/19 06:00
MHDA- 2022/11/19 06:01
PMCR- 2022/10/11
CRDT- 2022/11/18 02:07
PHST- 2022/10/11 00:00 [accepted]
PHST- 2022/11/18 02:07 [entrez]
PHST- 2022/11/19 06:00 [pubmed]
PHST- 2022/11/19 06:01 [medline]
PHST- 2022/10/11 00:00 [pmc-release]
AID - 10.7759/cureus.30189 [doi]
PST - epublish
SO  - Cureus. 2022 Oct 11;14(10):e30189. doi: 10.7759/cureus.30189. eCollection 2022 
      Oct.