A KRISHNAN1, A CHAKERA1, N BOUDVILLE1, D CHAN1, S DOGRA1, B HE1, B JACQUES1, L DELRIVERE1, C TING1, W LIM1
1Sir Charles Gairdner Hospital, Nedlands, Australia
Aim: To determine the factors associated with loss to follow-up of LKD and to evaluate changes in body weight post-donation.
Background: There is a small but significant risk of developing end-stage kidney and cardiovascular disease after donation, with relative risks up to 11-times compared to age-matched healthy population. Increased body weight is associated with kidney disease. Hence, donor follow-up is an important responsibility of the transplant community. Even though multiple donor and centre-specific factors have been identified to influence long-term outcome, there are no published data on factors relating to loss to follow-up of LKDs in Australia and New Zealand.
Methods: This was a single-centre retrospective study of 62 LKDs between 2013 and 2016. Factors associated with loss to follow-up and weight gain (defined as ≥10% increase in weight ≥12 months post-donation) were examined in adjusted logistic regression analyses.
Results: Eight of 62 (15%) were excluded (reallocated interstate/overseas) leaving a study cohort of 54 LKD, of which 43% were lost to follow-up within 12-months post-donation. In the adjusted model, younger donors (age >55 years: referent; age <40 years: adjusted odds ratio [OR] 7.29, [95%CI 1.03-3.25], p=0.05) and donors who experienced longer length of stay (LOS; adjusted OR 1.82, [95%CI 1.03-3.25], p=0.04) were more likely to not attend follow-up. Of the 28 (52%) donors who had follow-up weights ≥12 months post-donation, only 4 (14%) had gained over 10% in body weight at follow-up with no predictors of weight gain post-transplant.
Conclusions: Younger age and longer LOS were factors associated with loss to follow-up. Further detailed analysis evaluating the barriers to identify potentially modifiable risk factors in these donors will be critical to improve rates of follow-up.
Anoushka completed her advanced training in February this year, having trained in Perth for two years, followed by a year of training in Vancouver, Canada. She has a keen interest in renal transplantation, particularly cancer associated outcomes and donor outcomes.