Kidney transplants from incompatible live donors tied to significant survival benefit

Editor's Note

Patients who underwent desensitization therapy and received kidney transplants from HLA-incompatible live donors had a substantial survival benefit, compared with patients who did not undergo transplantation or those who waited for transplants from deceased donors, this study finds.

Researchers from Johns Hopkins, Baltimore, enrolled 1,025 patients at 22 centers who received kidney transplants from incompatible live donors. They were matched with controls who remained on the waiting list or received a transplant from a deceased donor.

Recipients of transplants from incompatible live donors had a higher survival rate than either control group at 1 year (95% vs 94% for the deceased donor group and 89.6% for the wait list group), 3 years (91.7% vs 83.6% and 72.7%, respectively), 5 years (86% vs 74.4% and 59.2%), and 8 years (76.5% vs 62.9% and 43.9%).

Many centers avoid transplanting kidneys from incompatible live donors because HLA incompatibilities are not accounted for in benchmarks, and centers performing such transplants may be subjected to regulatory scrutiny and loss of Centers for Medicare and Medicaid Services certification, the authors say.