Does Kidney Transplantation With Deceased or Living Donor Affect Graft Survival?

BACKGROUND There are growing numbers of patients with end-stage renal disease globally at an unexpected rate. Today, the most serious challenge in transplantation is organ shortage; hence, using deceased donor is increasingly encouraged. OBJECTIVES The aim of the study was to investigate the differences in survival rates between kidney transplant recipients with deceased donor and living donor. PATIENTS AND METHODS In a retrospective cohort study, 218 patients who had undergone kidney transplantation in our institute from April 2008 to September 2010 were recruited. Demographics and post-transplantation follow-up data including immunosuppression regimens, rejection episodes, and survival rates were evaluated. The patients were assigned to two groups according to the donor kidney transplantation: group I, living donor kidney transplants; and group II, deceased donor kidney transplants. RESULTS Although there were no significant differences in one-year survival rates of patient and graft between study groups, three-years survival rates of patient and graft were significantly longer in living donor kidney transplants in comparison with the deceased donor kidney recipients (P = 0.006 and P = 0.004, respectively). In Cox-regression model after adjusting for other confounding factors such as age, sex, diabetes mellitus, and first- or second-time transplantation, overall patient and graft survivals were also significantly shorter in deceased kidney transplantation than those who received kidney from a living donor (HR, 3.5; 95% CI, 1.2-10.4; and P = 0.02 for patient survival; and HR, 5.4; 95% CI, 1.5-19.5; and P = 0.009 for graft survival). CONCLUSIONS We found acceptable short-term survival in both groups; however, living donor recipients continue to have better long-term patient and graft survival rates.