Comparison of long-term outcomes between spousal transplants and other living unrelated donor transplants: single-center experience.
OBJECTIVE
The greater use of living unrelated donors (LUDs) as kidney donors is a worldwide trend in the current era of organ shortage, and spouses are an important source of LUDs. This study was to compare the long-term outcomes of spousal donor grafts with other LUD grafts.


METHODS
Among 445 LUD grafts, 77 were spouses and 368 were other LUDs. The clinical characteristics and long-term survival rates for spousal transplants were compared with those for other LUD transplants, and risk factors affecting graft survival were assessed.


RESULTS
Spousal donors had a significantly higher average number of human leukocyte antigen (HLA) mismatches (4.2 vs. 3.4, p < 0.001) and were older (41 vs. 33 years, p < 0.001) than LUDs. The 10-year survival rates for spousal donor grafts were 60.6%, similar to those for LUD grafts (58.5%, p = 0.61). The 10-year biopsy-proven acute rejection-free survival rates (85.5 vs. 89.6%, p = 0.45) and patient survival rates were also similar (84.3 vs. 79.6%, p = 0.35). The degree of HLA mismatching, the spousal donor type or donor age did not affect the graft survival.


CONCLUSIONS
Renal transplants from spousal donors show similar long-term outcomes to those from better HLA-matched and younger LUDs.
Yoon
Hye Eun
HE
Transplantation Research Center, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Song
Joon Chang
JC
Hyoung
Bok Jin
BJ
Hwang
Hyeon Seok
HS
Lee
So Young
SY
Jeon
Youn Joo
YJ
Park
Sun Cheol
SC
Choi
Bum Soon
BS
Kim
Yong Soo
YS
Moon
In Sung
IS
Yang
Chul Woo
CW
D058186:Acute Kidney Injury / Q000401:mortality* / Q000534:rehabilitation*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000145:classification / Q000401:mortality*; D007723:Korea / Q000453:epidemiology; D019520:Living Donors / Q000145:classification / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D018454:Spouses / Q000706:statistics & numerical data*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult