Outcome of Spousal versus Related Donor Renal Transplantation-A Retrospective Comparative Study

Introduction Kidney transplantation is the treatment of choice for end stage renal disease (ESRD). Living donor transplants contribute to majority of kidney transplants in India. Objectives of the study To assess the graft outcomes of Spousal donor (SD) transplants and to compare that with those of Related Donor (RD) transplants. Materials& methods Adults aged 18 years or more who underwent kidney transplantation from a SD or RD between January 2010 and October 2016 were included in the present study. Patients undergoing deceased were excluded from the study. Similarly, patients undergoing a second renal transplant, those with increased cold ischemia times (greater than 6 h), non-compliant with medications and those with no follow-up were excluded from the study. Outcome data at 6 months post-transplant was collected retrospectively from 2010 to 2016. Results A total of 211 live related renal transplants were performed at our hospital during the study period. Among those with complete follow-up (n=100) SDs constituted 30 % and remaining 70 percent were parents. The recipients in the SD group were significantly older than the RD group (mean age SD 42.2 8.3 years, RD 30.0 9.5 years, P less than 0.0001). The donors in the SD group were significantly younger (mean age SD 35.6 8.2 years, RD 45.2 11.5 years, P less than 0.0001). Acute rejection episodes were higher in the RD group as compared to the SD group (SD 16 %, RD 28.3 %, P =0.01). Among SD group, rejection rates were lower in patients who received induction therapy as compared to those who did not, the difference however was not statistically significant (induction-12.3 %, no-induction-18.8 %, P = 0.28). There was no difference in the incidence of infective complications following transplant, between the two recipient groups. Conclusions Outcomes of SD renal transplants are comparable to those of RD transplants. Better use of induction therapy helps in improving outcomes in these patients.