Feasible kidney donation with living marginal donors, including diabetes mellitus

Kasumi Yoshinaga, Motoo Araki, Koichiro Wada, Takanori Sekito, Shogo Watari, Yuki Maruyama, Yosuke Mitsui, Takuya Sadahira, Risa Kubota, Shingo Nishimura, Kohei Edamura, Yasuyuki Kobayashi, Katsuyuki Tanabe, Hidemi Takeuchi, Masashi Kitagawa, Shinji Kitamura, Jun Wada, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To compare the donor outcomes of living donor kidney transplantation between standard donors (SDs) and marginal donors (MDs) including diabetic patients (MD + DM). Methods: MDs were defined according to Japanese guideline criteria: (a) age >70-years, (b) blood pressure ≤130/80 mmHg on hypertension medicine, (c) body mass index >25 to ≤32 kg/m2, (d) 24-h creatinine clearance ≥70 to <80 ml/min/1.73 m2, and (e) hemoglobin A1c > 6.2 or ≤6.5 with oral diabetic medicine. Fifty-three of 114 donors were MDs. We compared donor kidney functions until 60 months postoperatively. Results: No kidney function parameters were different between SDs and MDs. When comparing SD and MD + DM, MD + DM had a lower postoperative eGFR (48 vs. 41 (1 (month), p =.02), 49 vs. 40 (12, p <.01), 48 vs. 42 (24, p =.04), 47 vs. 38 (36, p =.01)) and the percentage of residual eGFR (SD vs. MD + DM: 63 vs. 57 (1 (month), p <.01), 63 vs. 57 (2, p <.01), 64 vs. 56 (12, p <.01), 63 vs. 57 (24, p <.01), 63 vs. 52 (36, p =.02)). However, when MD with a single risk factor of DM was compared to SD, the difference disappeared. Nine out of 12 (75%) MD + DM had ≥2 risk factors. Conclusions: Although long-term observation of donor kidney function is necessary, careful MD + DM selection had the potential to expand the donor pool.

Original languageEnglish
Pages (from-to)1061-1068
Number of pages8
JournalImmunity, inflammation and disease
Volume9
Issue number3
DOIs
Publication statusPublished - Sep 2021

Keywords

  • diabetes mellitus
  • kidney function
  • kidney transplantation
  • marginal donor

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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