title: Donor factors predictive for poor outcomes of living donor kidney transplantation.
abstract: BACKGROUND
  The aim of this study was to explore donor risk factors that predict the poor outcomes after living donor kidney transplantation.
  
  
  METHODS
  We retrospectively analyzed our 219 living donor kidney transplantations collecting donor age and gender, graft glomeular filtration rate (GFR), human leukocyte antigen (HLA) typing, recipient age and gender, acute rejection episodes chronic rejection, and 1-year serum creatinine level. Patient and graft survivals were calculated using the Kaplan-Meier analysis. Independent donor risk factors affecting graft survival and 1-year serum creatinine level were analyzed using Cox regression and logistic regression.
  
  
  RESULTS
  One-, 3-, 5-year patient and graft survivals were 98.6%, 98.1%, and 97.4% and 97.7%, 95.0%, and 92.2%, respectively. Acute rejection rate was 12.8%, and chronic rejection, 4.1%. If donor age was over 50 years, there were significantly increased incidences of acute and chronic rejection (χ(2) were 5.385 and 5.039; P < .05). Univariate analysis showed donor age > 50 years, graft GFR < 35 mL/min, female to male, HLA mismatch > 3 loci to be risk factors for an abnormal 1-year serum creatinine. Logistic multivariate regression revealed donor age > 50 years, female to male, and graft GFR before transplant < 35 mL/min to be independent risk factors for an abnormal 1-year serum creatinine level (odds ratio values 5.928, 2.489, and 6.993, respectively; P < .05). Cox multivariate regression demonstrated that graft GFR before transplant < 35 mL/min was an independent risk factor for long-term graft survival (relative risk value = 6.984; P = .004).
  
  
  CONCLUSIONS
  Older donor, female to male, and insufficient graft GFR before transplantation are predictive factors for poor outcomes of living donor kidney transplantations.
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China.
authors.forename: G D
authors.initials: GD
authors.lastname: Chen
authors.forename: J L
authors.initials: JL
authors.lastname: Gu
authors.forename: X D
authors.initials: XD
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Qiu
authors.forename: C X
authors.initials: CX
authors.lastname: Wang
authors.forename: L Z
authors.initials: LZ
authors.lastname: Chen
mesh_terms: D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014019:Tissue Donors
chemical_list: D003404:Creatinine