LIVING UNRELATED RENAL DONATION - THE UNIVERSITY-OF-WISCONSIN EXPERIENCE

Background. Living unrelated renal donation (LURD) has the potential t o reduce the current waiting list significantly for kidney transplanta tion. The purpose of this study was to examine the long-term results o f 150 LURDs performed at our center during a 16-year period. Methods. From Dec 23, 1981, to Feb 13, 1998, 150 LURDs, 219 human leukocyte ant igen (HLA)-identical, 577 haploidentical, and 1789 cadaveric kidney tr ansplant procedures were performed. Surgical complications, rejection episodes, infectious complications, and the cause of graft loss and de ath were examined. Ten-year patient and graft survival rates between g roups were compared. Results. Fourteen surgical complications includin g lymphocele (n = 7), ureteral structure (n = 4), and ureteral leak (n = 3) were seen. Seventy-eight patients (52 %) had 123 rejection episo des and 66 patients (44 %) had 1 or more infections. Thirty-six allogr afts were lost and 25 deaths occurred. Patient survival rates at 10 ye ars for HLA-identical, haploidentical, LURD, and cadaveric trans plant procedures were 86%, 82%, 63%, and 64%, respectively. Allograft survi val rates at 10 years for HLA-identical, haploidentical, LURD, and cad aver transplant procedures were 75%, 59%, 56%, and 44%, respectively. Conclusions. Long-term LURD allograft survival rates are lower than th ose for HLA-identical but equivalent to those of haploidentical and be tter than those of cadaveric kidney transplantations. Spousal and nons pousal LURDs should be actively encouraged to help alleviate the curre nt donor kidney shortage.