Impact of donor hypertension on graft survival and function in living and deceased donor kidney transplantation: a nationwide prospective cohort study
- Authors
- Lee, Y.H.; Kim, J.S.; Song, S.H.; Song, S.H.; Shin, H.S.; Yang, J.; Ahn, C.; Jeong, K.H.; Hwang, H.S.; Kong, J.M.; Kwon, O.J.; Kim, D.G.; Jung, C.-W.; Kim, Y.H.; Kim, J.K.; Kim, C.-D.; Min, J.W.; Park, S.K.; Park, Y.H.; Berm, P.J.; Park, J.H.; Park, J.-W.; Ban, T.H.; Yang, C.W.; Yoon, H.E.; Lee, K.W.; Lee, D.R.; Lee, D.W.; Lee, S.Y.; Lee, S.-H.; Lee, S.H.; Lee, J.J.; Lee, J.P.; Lee, J.-H.; Jeon, J.S.; Jun, H.; Chung, K.Y.; Cho, H.R.; Ki, J.M.; Chae, D.-W.; Choi, S.J.N.; Han, D.J.; Han, S.; Huh, K.H.
- Issue Date
- Nov-2022
- Publisher
- Lippincott Williams and Wilkins
- Keywords
- donor hypertension; kidney transplantation; renal allograft function; renal allograft survival
- Citation
- Journal of Hypertension, v.40, no.11, pp.2200 - 2209
- Journal Title
- Journal of Hypertension
- Volume
- 40
- Number
- 11
- Start Page
- 2200
- End Page
- 2209
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/87146
- DOI
- 10.1097/HJH.0000000000003246
- ISSN
- 0263-6352
- 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. © 2022 Wolters Kluwer Health, Inc.
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