title: Spousal versus living unrelated renal transplantation: a retrospective analysis of allograft outcomes.
abstract: OBJECTIVE
  To compare the outcomes of spousal and living unrelated donor (LUD) allografts.
  
  
  METHODS
  The 378 ABO-compatible living and cadaveric kidney transplantations between February 2005 and August 2010 included 25 wife-to-husband (group 1), 15 husband-to-wife (group 2), and 20 LUD cases (group 3). Donor nephrectomy was performed by open surgery. Induction therapy with antithymocyte globulin or anti-interleukin-2 receptor antibody was followed by maintenance regimens using cyclosporine (CsA) or tacrolimus (Tac) plus mycophenolate mofetil (MMF) and corticosteroids. We compared spousal donor and LUDs in terms of clinical characteristics as well as graft and patient survival rates.
  
  
  RESULTS
  Fifty-six (93.3%) patients underwent induction therapy with either antithymocyte globulin (n = 30) or anti-interleukin-2 receptor antibody (n = 26). Maintenance immunosuppression was administered with Tac + MMF (n = 37; 61.6%) or CsA + MMF (n = 23; 38.4) with corticosteroids. Mean follow-up was 34 ± 16 months. There were four graft losses and five patient deaths. There were no significant differences between spousal and living unrelated transplants in terms of clinical characteristics or biopsy-proven acute rejection episodes. The Kaplan-Meier analysis showed 3-year patient survival rates of 94%, 100%, and 88% in group 1, group 2, and group 3, respectively (P > .05). Overall graft survival rates were 94%, 100%, and 77% in group 1, group 2, and group 3, respectively (P > .05). Graft and patient survival rates were similar at 3 years for wife-to-husband, husband-to-wife, or LUDs.
  
  
  CONCLUSIONS
  In conclusion, family members should be encouraged as LUD or spousal donors, based on similar patient and graft survival rates.
authors: Department of General Surgery, Ege University, School of Medicine, Izmir, Turkey. taylan.ozgur.sezer@ege.edu.tr
authors: I
authors: I
authors: Solak
authors: T O
authors: TO
authors: Sezer
authors: H
authors: H
authors: Toz
authors: E
authors: E
authors: Tatar
authors: C
authors: C
authors: Isayev
authors: O
authors: O
authors: Firat
authors: C
authors: C
authors: Hoscoskun
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D016009:Chi-Square Distribution; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018454:Spouses; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents