Outcomes among Recipients of Older Hypertensive Living Donor Kidneys

There have been data reported supporting the long-term safety of nephrectomy in donors with hypertension. However, according to A. Sharfuddin and colleagues at Indiana University School of Medicine, Indianapolis, there are few long-term data on outcomes among recipients of kidneys from donors with hypertension. The use of older hypertensive donors, those ≥60 years of age, is rare and there are only minimal data on outcomes among recipients of kidneys from hypertensive donors >60 years of age.

The researchers conducted a study to examine the demographics of older living donors and their recipient outcomes in the United States. Results of the study were reported during a virtual poster session at the American Transplant Congress in a poster titled Kidney Transplant Recipient Outcomes from Older (60+) Hypertensive Living Donors.

The retrospective review utilized the United States United Network for Organ Sharing database for the period January 2000 through December 2016. Pediatric and multiorgan transplant recipients were excluded and the time period was limited to minimum 1-year follow-up.

Of the 111,483 living donors during the study period, 5.1% (n=5695) were ≥60 years of age and met study criteria. Of the 5695, 9.3% (n=531) were hypertensive. Median follow-up was 4.6 years.

There were no statistically significant differences between recipients with older hypertensive versus older non-hypertensive donors in all-cause unadjusted graft survival (P=.57), death-censored graft survival (P=.79), or patient survival (P=.52). There were no differences between the two groups in race, sex, dialysis, delayed graft function, or acute rejection. In the hypertensive living donor group, there was no difference in graft survival between recipient race, sex, donor race, and acute rejection. Compared with donors 60 to 64 years of age, graft survival was inferior in donors >65 years of age (P=.0005) in both hypertensive and non-hypertensive donors (P=.035).

In conclusion, the researchers said, “Transplant recipient outcomes from older hypertensive living donors are favorable and comparable to those donors without hypertension. Careful selection of such donors and matching to appropriate recipients should not be discouraged when such donors are available.”

Source: Sharfuddin A, Taber T, Adebiyi O, Panezai M, Mishler D, Yaqub M. Kidney transplant recipient outcomes from older (60+) hypertensive living donors. Abstract of a poster presented at the virtual American Transplant Congress 2020 (Abstract A-079), May 30, 2020.