Living unrelated donor kidney transplantation

Kidney Int. 2000 Aug;58(2):491-9. doi: 10.1046/j.1523-1755.2000.00195.x.


Background: Living unrelated donors remain an underutilized resource, despite their high graft survival rates. In this article, we updated the long-term results of more than 2500 living unrelated donor transplants performed in the United States.

Methods: Between 1987 and 1998, 1765 spouse, 986 living unrelated, 27,535 living related, and 86,953 cadaver donor grafts were reported to the United Network for Organ Sharing Kidney Registry. Kaplan-Meier curves compared graft survival rates in stratified analyses, and a log-linear analysis adjusted donor-specific outcomes for the effects of 24 other transplant factors.

Results: The long-term survival rates for both spouse and living unrelated transplants were essentially the same (5-year graft survivals of 75 and 72% and half-lives of 14 and 13 years, respectively). The results were similar to that for parent donor grafts (5-year graft survival = 74% and half-life = 12 years) and were significantly (P = 0.003) better than cadaver donor grafts (5-year graft survival = 62% and half-life = 9 years). After adjusting for the presence of transplant factors known to influence survival rates, recipients of living unrelated donor kidney transplants still had superior outcomes compared with cadaver transplants.

Conclusions: Living unrelated kidney donors represent the fastest growing donor source in the United States and provide excellent long-term results. Encouraging spouses to donate could remove nearly 15% of the patients from the UNOS waiting list, effectively increasing the number of available cadaveric organs.

MeSH terms

  • Adult
  • Cadaver
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Histocompatibility Testing
  • Humans
  • Kidney Failure, Chronic / mortality*
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / mortality*
  • Living Donors / statistics & numerical data*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Registries / statistics & numerical data*
  • Spouses / statistics & numerical data
  • Survival Analysis
  • United States / epidemiology
  • Waiting Lists