Impact of donor hypertension on graft survival and function in living and deceased donor kidney transplantation: a nationwide prospective cohort study

KOTRY study group

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Hypertensive living donors are potential candidates to expand the kidney donor pool. However, the impact of donor hypertension on graft survival and function remains to be clarified. Methods: We analyzed 3907 kidney transplant recipients registered in a nationwide prospective cohort from 2014 to 2018. Patients were divided by donor types and the presence of donor hypertension. The primary and secondary outcome was the occurrence of death-censored graft failure and renal allograft function, respectively. Results: The prevalence of hypertension was 9.4% (258/2740) and 19.9% (232/1167) in living and deceased donors, respectively. During a median follow-up of 21.8months, death-censored graft survival rate was significantly worse in recipients of hypertensive living donors than in those of normotensive living donors (P¼0.008). In multivariable analysis, recipients of hypertensive living donors had a significantly increased risk of graft loss (adjusted hazard ratio 2.91; P¼0.009). The risk of allograft loss was not different between recipients of hypertensive living and normotensive deceased donors. Propensity score-matched analyses had consistent worse graft survival rate in recipients of hypertensive living donors compared to those of normotensive living donors (P¼0.027), while it was not different between recipients of hypertensive living and normotensive deceased donors. Hypertension in living donors had a significant negative impact on one-year graft function (adjusted unstandardized b -3.64; P¼0.011). Conclusions: Hypertensive living donor recipients have significantly higher risks of renal allograft loss than normotensive living donor recipients, and showed similar outcomes compared to recipients of normotensive deceased donors.

Original languageEnglish
Pages (from-to)2200-2209
Number of pages10
JournalJournal of Hypertension
Volume40
Issue number11
DOIs
StatePublished - 1 Nov 2022

Bibliographical note

Publisher Copyright:
© 2022 Wolters Kluwer Health, Inc.

Keywords

  • donor hypertension
  • kidney transplantation
  • renal allograft function
  • renal allograft survival

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