J. McLeod1, C. Carroll1, W. Summers1, C. Baxter1, R. Deierhoi1, P. MacLennan1, J. E. Locke1 1University Of Alabama,Birmingham, Alabama, USA
Introduction: Living donor selection practices aim to quantify lifetime risk of comorbid disease development (e.g. hypertension, diabetes, kidney disease) based on candidate’s pre-donation demographic and health characteristics at the time of evaluation. Studies aimed at predicting this risk have been limited by lack of information on donor relationship or family history. The goal of this study was to better understand the relationship between donor-recipient relationship and risk for post-donation comorbid disease development.
Methods: Participants enrolled in an IRB approved study agreed to survey examination and consented for medical record abstraction, allowing for capture of baseline health characteristics and post-donation outcomes. We used descriptive statistics and logistic regression to examine the odds of comorbid disease by donor-recipient relationship (adjusted for age, ethnicity, gender).
Results:59 adult living kidney donors were studied; median age at donation 43.3 (IQR: 38.9-56.7); median age at survey 64.5 (IQR: 51.2-69.7); 54 European American and 5 African American; with median follow-up of 6.6 years (IQR: 4.3-29.2). More than half of the cohort was related to their recipient (Related: 67% vs. Unrelated: 33%). Twenty living kidney donors developed comorbid disease over the course of the study. Hypertension was the most common post-donation comorbidity. Interestingly, 19 of 20 post-donation comorbidities developed in related donors. Related donors had a 17-fold higher odds of developing a post-donation comorbidity compared to their unrelated donor counterparts (adjusted odds ratio: 17.00, 95%CI: 1.84-157.08, p=0.01).
Conclusion:Donor-recipient relationship was strongly correlated with development of post-donation comorbidities. This finding suggests the potential for some underlying genetic susceptibility carried by family members and warrants further study.
