Dataset Information

Safety, clinical and laboratory characteristics of donors with thalassemia minor in living donor kidney transplant: a case series.

ABSTRACT:

Background

Due to the increasing demand for kidney transplants, sometimes donors with underlying medical conditions can be considered for living kidney donor transplant. Thalassemia is amongst the most common inherited disorders of hemoglobin globally, which is not restricted as an exclusion criterion. However, there is currently no study examine the safety and characteristics of kidney donors with thalassemia minor.

Methods

All eligible live kidney donors between 2016 and 2019 with thalassemia minor at a tertiary hospital were recruited. Baseline characteristics, clinical and laboratory outcomes were investigated.

Results

Fifteen donors (11 women, 55.5 ± 15.0 year-old) were included with a follow-up duration of 2 (1-4) years since operation. The most prevalent gene mutation among participants was DEL-SEA. No clinical manifestations of anemia were seen but 10 participants had mild anemia diagnosed from blood tests. Cardiovascular, liver and renal function were normal before nephrectomy. Until now, all donors are alive and maintain overall good health. Anemia condition is not affected, and the post-donation eGFR = 71.04 ± 11.54 mL/min/1.73m² is comparable to outcomes of healthy donors reported in previous studies. Two donors are at risk of proteinuria at 1-year post-transplant with A/C ratio > 30 mg/g.

Conclusions

Thalassemia minor individuals who are non-transfusion-dependent, without anemia clinical manifestations and have no contraindications to kidney donation are safe to be donors in short-term. An eGFR of at least 80 mL/min/1.73m² should be considered to avoid low post-donation eGFR, and awareness should be raised on thalassemia donors with even mild albuminuria. Nephrectomy does not worsen thalassemia.

SUBMITTER: Dinh NH

PROVIDER: S-EPMC8638172 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Publications

Safety, clinical and laboratory characteristics of donors with thalassemia minor in living donor kidney transplant: a case series.

Dinh Nhan Hieu NH Beaupha Suzanne Monivong Cheanh SMC

BMC nephrology 20211201 1

<h4>Background</h4>Due to the increasing demand for kidney transplants, sometimes donors with underlying medical conditions can be considered for living kidney donor transplant. Thalassemia is amongst the most common inherited disorders of hemoglobin globally, which is not restricted as an exclusion criterion. However, there is currently no study examine the safety and characteristics of kidney donors with thalassemia minor.<h4>Methods</h4>All eligible live kidney donors between 2016 and 2019 wi ...[more]

PMID: 34852778

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Project description:Background and objectivesIn kidney transplantation, the relative contribution of donor versus other factors on clinical outcomes is unknown. We sought to quantify overall donor effects on transplant outcomes for kidney donations from deceased donors.Design, setting, participants, & measurementsFor paired donations from deceased donors resulting in transplants to different recipients, the magnitude of donor effects can be quantified by examining the excess of concordant outcomes within kidney pairs beyond chance concordance. Using data from the Organ Procurement and Transplantation Network between the years 2013 and 2017, we examined concordance measures for delayed graft function, death-censored 1-year graft failure, and death-censored 3-year graft failure. The concordance measures were excess relative risk, excess absolute risk, and the fixation index (where zero is no concordance and one is perfect concordance). We further examined concordance in strata of kidneys with similar values of the Kidney Donor Profile Index, a common metric of organ quality.ResultsIf the transplant of the kidney mate resulted in delayed graft function, risk for delayed graft function was 19% higher (95% confidence interval [95% CI], 18% to 20%), or 1.76-fold higher (95% CI, 1.73- to 1.80-fold), than baseline. If a kidney graft failed within 1 year, then the kidney mate's risk of failure was 6% higher (95% CI, 4% to 9%), or 2.85-fold higher (95% CI, 2.25- to 3.48-fold), than baseline. For 3-year graft failure, the excess absolute risk was 7% (95% CI, 4% to 10%) but excess relative risk was smaller, 1.91-fold (95% CI, 1.56- to 2.28-fold). Fixation indices were 0.25 for delayed graft function (95% CI, 0.24 to 0.27), 0.07 for 1-year graft failure (95% CI, 0.04 to 0.09), and 0.07 for 3-year graft failure (95% CI, 0.04 to 0.10). Results were similar in strata of kidneys with a similar Kidney Donor Profile Index.ConclusionsOverall results indicated that the donor constitution has small or moderate effect on post-transplant clinical outcomes.

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Dataset Information

Safety, clinical and laboratory characteristics of donors with thalassemia minor in living donor kidney transplant: a case series.

Background

Methods

Results

Conclusions

Publications

Safety, clinical and laboratory characteristics of donors with thalassemia minor in living donor kidney transplant: a case series.

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