Publication:
Propensity score-matched analysis of long-term outcomes for living kidney donation in alternative complement pathway diseases: a pilot study

dc.contributor.coauthorCaliskan, Yasar
dc.contributor.coauthorSafak, Seda
dc.contributor.coauthorOto, Ozgur Akin
dc.contributor.coauthorVelioglu, Arzu
dc.contributor.coauthorMirioglu, Safak
dc.contributor.coauthorDirim, Ahmet Burak
dc.contributor.coauthorYildiz, Abdulmecit
dc.contributor.coauthorGuller, Nurana
dc.contributor.coauthorYazici, Halil
dc.contributor.coauthorErsoy, Alparslan
dc.contributor.coauthorTurkmen, Aydin
dc.contributor.coauthorLentine, Krista L.
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.kuauthorYelken, Berna
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.date.accessioned2024-11-09T23:04:11Z
dc.date.issued2023
dc.description.abstractBackground: Atypical hemolytic syndrome (aHUS) and C3 glomerulopathy (C3G) are complement-mediated rare diseases with excessive activation of the alternative pathway. Data to guide the evaluation of living-donor candidates for aHUS and C3G are very limited. The outcomes of living donors to recipients with aHUS and C3G (Complement disease-living donor group) were compared with a control group to improve our understanding of the clinical course and outcomes of living donation in this context. Methods: Complement disease-living donor group [n = 28; aHUS(53.6%), C3G(46.4%)] and propensity score-matched control-living donor group (n = 28) were retrospectively identified from 4 centers (2003–2021) and followed for major cardiac events (MACE), de novo hypertension, thrombotic microangiopathy (TMA), cancer, death, estimated glomerular filtration rate (eGFR) and proteinuria after donation. Results: None of the donors for recipients with complement-related kidney diseases experienced MACE or TMA whereas two donors in the control group developed MACE (7.1%) after 8 (IQR, 2.6–12.8) years (p = 0.15). New-onset hypertension was similar between complement disease and control donor groups (21.4% vs 25%, respectively, p = 0.75). There were no differences between study groups regarding last eGFR and proteinuria levels (p = 0.11 and p = 0.70, respectively). One related donor for a recipient with complement-related kidney disease developed gastric cancer and another related donor developed a brain tumor and died in the 4th year after donation (2, 7.1% vs none, p = 0.15). No recipient had donor-specific human leukocyte antigen antibodies at the time of transplantation. Median follow-up period of transplant recipients was 5 years (IQR, 3–7). Eleven (39.3%) recipients [aHUS (n = 3) and C3G (n = 8)] lost their allografts during the follow-up period. Causes of allograft loss were chronic antibody-mediated rejection in 6 recipients and recurrence of C3G in 5. Last serum creatinine and last eGFR of the remaining patients on follow up were 1.03 ± 038 mg/dL and 73.2 ± 19.9 m/min/1.73 m2 for aHUS patients and 1.30 ± 0.23 mg/dL and 56.4 ± 5.5 m/min/1.73 m2 for C3G patients. Conclusion: The present study highlights the importance and complexity of living related-donor kidney transplant for patients with complement-related kidney disorders and motivates the need for further research to determine the optimal risk-assessment for living donor candidates to recipients with aHUS and C3G.
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.indexedbyWOS
dc.description.openaccessYES
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.sponsorshipThis work was conducted under the support provided to Istanbul University by The Scientific and Technological Research Council of Turkey (TÜBİTAK). Project no 114S261. The opinions, results, and conclusions reported in this article are those of the authors and are independent of the funding sources.
dc.identifier.doi10.1007/s40620-023-01588-x
dc.identifier.issn1121-8428
dc.identifier.scopus2-s2.0-85148451284
dc.identifier.urihttps://doi.org/10.1007/s40620-023-01588-x
dc.identifier.urihttps://hdl.handle.net/20.500.14288/8577
dc.identifier.wos936486800002
dc.keywordsAtypical hemolytic uremic syndrome
dc.keywordsC3 glomerulopathy
dc.keywordsComplement
dc.keywordsKidney
dc.keywordsLiving donation
dc.keywordsTransplantation
dc.language.isoeng
dc.publisherSpringer Science and Business Media Deutschland GmbH
dc.relation.ispartofJournal of Nephrology
dc.subjectAtypical hemolytic uremic syndrome
dc.subjectC3 glomerulopathy
dc.subjectComplement
dc.subjectKidney
dc.subjectTransplantation
dc.subjectLiving donation
dc.titlePropensity score-matched analysis of long-term outcomes for living kidney donation in alternative complement pathway diseases: a pilot study
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorYelken, Berna
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
relation.isOrgUnitOfPublicationf91d21f0-6b13-46ce-939a-db68e4c8d2ab
relation.isOrgUnitOfPublication.latestForDiscoveryf91d21f0-6b13-46ce-939a-db68e4c8d2ab
relation.isParentOrgUnitOfPublication055775c9-9efe-43ec-814f-f6d771fa6dee
relation.isParentOrgUnitOfPublication.latestForDiscovery055775c9-9efe-43ec-814f-f6d771fa6dee

Files