title: Comparison of long-term outcomes between spousal transplants and other living unrelated donor transplants: single-center experience.
abstract: 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.
authors.affiliation: Transplantation Research Center, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hye Eun
authors.initials: HE
authors.lastname: Yoon
authors.forename: Joon Chang
authors.initials: JC
authors.lastname: Song
authors.forename: Bok Jin
authors.initials: BJ
authors.lastname: Hyoung
authors.forename: Hyeon Seok
authors.initials: HS
authors.lastname: Hwang
authors.forename: So Young
authors.initials: SY
authors.lastname: Lee
authors.forename: Youn Joo
authors.initials: YJ
authors.lastname: Jeon
authors.forename: Sun Cheol
authors.initials: SC
authors.lastname: Park
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: In Sung
authors.initials: IS
authors.lastname: Moon
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
mesh_terms: 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