AUTHOR=El-Rifai Rasha , Bregman Adam , Klomjit Nattawat , Spong Richard , Jackson Scott , Nachman Patrick H. , Riad Samy 

TITLE=Living Donor Kidney Transplant in Recipients With Glomerulonephritis: Donor Recipient Biologic Relationship and Allograft Outcomes

JOURNAL=Transplant International

VOLUME=36

YEAR=2023

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2023.11068

DOI=10.3389/ti.2023.11068

ISSN=1432-2277

ABSTRACT=<p>Using the Scientific Registry of Transplant Recipients, we examined the association between donor-recipient biologic relationship and long-term recipient and allograft survival among glomerulonephritis (GN) patients. Four GN types were studied: membranous nephropathy, IgA, lupus-associated nephritis, and focal segmental glomerulosclerosis (FSGS). We identified all adult primary living-donor recipients between 2000 and 2018 (<italic>n</italic> = 19,668): related (<italic>n</italic> = 10,437); unrelated (<italic>n</italic> = 9,231). Kaplan-Meier curves were generated for the recipient, death-censored graft survival and death with functioning graft through ten years post-transplant. Multivariable Cox proportional hazard models were used to examine the association between the donor-recipient relationship and outcomes of interest. There was an increased risk for acute rejection by 12 months post-transplant among the unrelated compared to the related group in IgA (10.1% vs. 6.5%, p&lt;0.001), FSGS (12.1% vs. 10%, <italic>p</italic>-0.016), and lupus nephritis (11.8% vs. 9.2%; <italic>p</italic>-0.049). The biological donor-recipient relationship was not associated with a worse recipient or graft survival or death with functioning graft in the multivariable models. These findings are consistent with the known benefits of living-related-donor kidney transplants and counter the reports of the potential adverse impact of the donor-recipient biologic relationship on allograft outcomes.</p>