16 September 2025 : Original article
Effect of Recipient Variables on Transplant Survival Following Marginal Kidney Donation: Analysis of a Mate Kidney Cohort
Ariadni Androvitsanea ABCDEF 1,2*, Katharina M. Heller AB 1, Hendrik Apel BD 3, Frank Kunath
BD 3, Peter J. Goebell E 3, Bernd Wullich BDF 3, Ulrich Rother EF 4, Christoph Daniel BCDE 5, Kerstin Amann ABCD 5, Carsten Willam ABCDEG 1, Mario Schiffer ADE 1
DOI: 10.12659/AOT.948739
Ann Transplant 2025; 30:e948739
Table 1 Recipient and transplant characteristics.
| Recipient and transplant characteristics | Recipients (n=200) |
|---|---|
| Age (KTx_date) | 58 |
| Gender (male), n (%) | 144 (72) |
| Time on dialysis before kidney transplantation (months), mean±SD | 62.84±37.45 |
| Recipient BMI (kg/m), mean±SD | 25.55±3.98 |
| Diabetes mellitus, n (%) | 35 (17.5) |
| Cardiovascular disease, n (%) | 56 (28) |
| Glomerulonephritis | 44 (22) |
| Unknown | 38 (19) |
| ADPKD | 31 (15.5) |
| DM | 21 (10.5) |
| Hypertension | 27 (13.5) |
| Obstructive nephropathy | 7 (3.5) |
| Urological abnormalities | 5 (2.5) |
| Autoimmune disorders | 7 (3.5) |
| Pyelonephritis interstitial nephritis | 10 (5) |
| Others (metabolic, reduced renal mass etc.) | 10 (5) |
| Cold ischemia time (hours), mean±SD | 11:53±4:43 |
| Secondary warm ischemia time (minutes), mean±SD | 44±19.8 |
| Nr of mismatches (MM) for HLA-A, -B, -DR loci, mean±SD | 4.22±1.37 |
| <6% | 184 (92) |
| 6–85% | 15 (7.5) |
| >85% | 0 (0) |
| First kidney transplant | 183 (91.5) |
| Simultaneously kidney-pancreas transplant | 6 (3) |
| Second or third kidney transplant | 11 (5.5) |
| Expanded-criteria donors (ECD) | 200 |
| Included combined kidney-pancreas transplantations | 6 |
| IL-2 receptor antibodies | 129 (64.5) |
| Antithymoglobulin | 55 (27.5) |
| None | 10 (5) |
| Rituximab | 1 (0.5) |
| Antithymoglobulin & plasma exchange | 4 (2) |
| CNI (Tac or CyA), MPAA, steroids | 193 (96.5) |
| mTORi, MPAA, steroids | 3 (1.5) |
| mTORi, CNI, steroids | 1 (0.5) |
| MPAA, steroids | 3 (1.5) |
| Primary function | 130 (65) |
| Delayed graft function | 59 (29.5) |
| Permanent non-function | 11 (5.5) |
| 93 (46.5) | |
| Early rejection, ER (<1year) | 57 |
| Late rejection, LR (≥1year) | 19 |
| Multiple, repetitive rejections (ER+LR) | 14 |
| Borderline rejections (subgroup of aCMR) | 28 |
| AB-mediated rejections (acute or chronic) (ABMR) | 24 |
| Acute cellular mediated rejection (aCMR) | 70 |
| Yes | 186 |
| No | 14 |
| Mean number of glomeruli | 9 |
| None | 19 |
| Mild | 41 |
| Moderate | 84 |
| Severe | 42 |
| 0–5% (ci 0) | 126 |
| 6–25% (ci 1) | 70 |
| 26–50% (ci 2) | 4 |
| None (cv 0) | 88 |
| 0–25% (cv 1) | 65 |
| 26–50% (cv 2) | 32 |
| None (ah 0) | 127 |
| Mild to moderate in ≥1 (ah 1) | 35 |
| Moderate to severe I >1 (ah 2) | 35 |
| Severe in many (ah3) | 3 |
| None (ct 0) | 64 |
| <25% (ct 1) | 132 |
| 26–50% (ct 2) | 4 |
| <10% (i 0) | 177 |
| 10–25% (i 1) | 23 |
| 26–50% (i 2) | 0 |
| >50% (i 3) | 0 |
| (percentage of sclerosed glomeruli) | |
| <10% | 118 |
| >10% | 68 |
| ADPKD – autosomal dominant kidney disease; PRA% – panel-reactive antibodies; CNI – calcineurin inhibitors (tacrolimus/cyclosporin); MPAA – mycophenolate acid agents; mTORi – mammalian target of rapamycin inhibitors; IL-2 – interleukin 2 antagonist; AB-mediated rejection – antibody-mediated rejection. | |