graft survival;
long term outcomes;
disease recurrence;
living related donor;
glomerulonephritis;
FOCAL SEGMENTAL GLOMERULOSCLEROSIS;
LUPUS NEPHRITIS;
RISK;
NEPHROPATHY;
SURVIVAL;
GENE;
D O I:
10.3389/ti.2023.11068
中图分类号:
R61 [外科手术学];
学科分类号:
摘要:
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 (n = 19,668): related (n = 10,437); unrelated (n = 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<0.001), FSGS (12.1% vs. 10%, p-0.016), and lupus nephritis (11.8% vs. 9.2%; p-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.
机构:
Columbia Univ, Dept Med, Med Ctr, Div Nephrol, New York, NY USA
Columbia Univ Renal Epidemiol CURE Grp, New York, NY USAColumbia Univ, Dept Med, Med Ctr, Div Nephrol, New York, NY USA
Husain, S. Ali
King, Kristen L.
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机构:
Columbia Univ, Dept Med, Med Ctr, Div Nephrol, New York, NY USA
Columbia Univ Renal Epidemiol CURE Grp, New York, NY USAColumbia Univ, Dept Med, Med Ctr, Div Nephrol, New York, NY USA
King, Kristen L.
Sanichar, Navin
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机构:
Columbia Univ, Mailman Sch Publ Hlth, Dept Biostat, New York, NY USAColumbia Univ, Dept Med, Med Ctr, Div Nephrol, New York, NY USA
Sanichar, Navin
Crew, R. John
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机构:
Columbia Univ, Dept Med, Med Ctr, Div Nephrol, New York, NY USAColumbia Univ, Dept Med, Med Ctr, Div Nephrol, New York, NY USA
Crew, R. John
Schold, Jesse D.
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机构:
Cleveland Clin, Lerner Res Inst, Ctr Populat Hlth Res, Cleveland, OH 44106 USA
Cleveland Clin, Dept Quantitat Hlth Sci, Cleveland, OH 44106 USAColumbia Univ, Dept Med, Med Ctr, Div Nephrol, New York, NY USA
机构:
UCL, NIHR Great Ormond St Hosp Biomed Res Ctr, Great Ormond St Inst Child Hlth, London, EnglandUCL, NIHR Great Ormond St Hosp Biomed Res Ctr, Great Ormond St Inst Child Hlth, London, England
Mudalige, Nadeesha L.
Brown, Chloe
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机构:
Natl Hlth Serv Blood & Transplant, Bristol, Avon, EnglandUCL, NIHR Great Ormond St Hosp Biomed Res Ctr, Great Ormond St Inst Child Hlth, London, England
Brown, Chloe
Marks, Stephen D.
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机构:
UCL, NIHR Great Ormond St Hosp Biomed Res Ctr, Great Ormond St Inst Child Hlth, London, England
Great Ormond St Hosp Children NHS Fdn Trust, Dept Paediat Nephrol, Great Ormond St, London WC1N 3JH, EnglandUCL, NIHR Great Ormond St Hosp Biomed Res Ctr, Great Ormond St Inst Child Hlth, London, England
机构:
Minneapolis Med Res Fdn Inc, SRTR, Minneapolis, MN USAMinneapolis Med Res Fdn Inc, SRTR, Minneapolis, MN USA
Skeans, M.
Snyder, J.
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机构:
Minneapolis Med Res Fdn Inc, SRTR, Minneapolis, MN USAMinneapolis Med Res Fdn Inc, SRTR, Minneapolis, MN USA
Snyder, J.
Matas, A.
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机构:
Minneapolis Med Res Fdn Inc, SRTR, Minneapolis, MN USA
Univ Minnesota, Dept Surg, Minneapolis, MN 55455 USAMinneapolis Med Res Fdn Inc, SRTR, Minneapolis, MN USA