Renal Outcomes and Surgical Results of Marginal Donors in Living Kidney Transplantation

Abstract

In recent years, the number of living kidney transplantation from marginal donors, who fall into the borderline category for kidney transplant eligibility, has increased in Japan. This study involved living donors who underwent laparoscopic nephrectomy for transplant between 2015 and 2022 at our center. Donors were categorized into the following two groups : the Standard Donor (SD) group and the Marginal Donor (MD) group. We examined the renal outcomes and surgical results of the donors, as well as the risk factors for renal outcomes. Out of 201 living donors, 131 were classified into the SD group and 70 into the MD group. The estimated glomerular filtration rate (eGFR) from discharge to 3 years post-surgery was low in the MD group compared with the other. Surgical outcomes were comparable between the two groups. Preoperative low renal function and advanced age were identified as risk factors, with a tendency for poorer renal outcomes in donors with multiple marginal factors. The MD group exhibited poor renal outcomes compared with the SD group. Donors with low renal function or advanced age, as well as those with multiple marginal factors, require close attention regarding long-term kidney outcomes.