Open AccessFeasible kidney donation with living marginal donors, including diabetes mellitus
Author(s) -
Yoshinaga Kasumi,
Araki Motoo,
Wada Koichiro,
Sekito Takanori,
Watari Shogo,
Maruyama Yuki,
Mitsui Yosuke,
Sadahira Takuya,
Kubota Risa,
Nishimura Shingo,
Edamura Kohei,
Kobayashi Yasuyuki,
Tanabe Katsuyuki,
Takeuchi Hidemi,
Kitagawa Masashi,
Kitamura Shinji,
Wada Jun,
Watanabe Masami,
Watanabe Toyohiko,
Nasu Yasutomo
Publication year - 2021
Publication title -
immunity, inflammation and disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 18
ISSN - 2050-4527
DOI - 10.1002/iid3.470
Subject(s) - medicine , renal function , urology , hemoglobin , creatinine , body mass index , gastroenterology , diabetes mellitus , kidney , kidney transplantation , endocrinology
Objectives To compare the donor outcomes of living donor kidney transplantation between standard donors (SDs) and marginal donors (MDs) including diabetic patients (MD + DM). Methods MDs were defined according to Japanese guideline criteria: (a) age >70‐years, (b) blood pressure ≤130/80 mmHg on hypertension medicine, (c) body mass index >25 to ≤32 kg/m 2 , (d) 24‐h creatinine clearance ≥70 to <80 ml/min/1.73 m 2 , and (e) hemoglobin A1c > 6.2 or ≤6.5 with oral diabetic medicine. Fifty‐three of 114 donors were MDs. We compared donor kidney functions until 60 months postoperatively. Results No kidney function parameters were different between SDs and MDs. When comparing SD and MD + DM, MD + DM had a lower postoperative eGFR (48 vs. 41 (1 (month), p = .02), 49 vs. 40 (12, p < .01), 48 vs. 42 (24, p = .04), 47 vs. 38 (36, p = .01)) and the percentage of residual eGFR (SD vs. MD + DM: 63 vs. 57 (1 (month), p < .01), 63 vs. 57 (2, p < .01), 64 vs. 56 (12, p < .01), 63 vs. 57 (24, p < .01), 63 vs. 52 (36, p = .02)). However, when MD with a single risk factor of DM was compared to SD, the difference disappeared. Nine out of 12 (75%) MD + DM had ≥2 risk factors. Conclusions Although long‐term observation of donor kidney function is necessary, careful MD + DM selection had the potential to expand the donor pool.