To compare the clinical effects of kidney transplantation between donation after citizen′s death and living organ donation at a single center.

Two hundred and fifty-four kidney transplant recipients who completed in the First Affiliated Hospital of Anhui Medical University from January 1, 2017 to December 31, 2018 and had complete follow-up data were incorporated into the study, and were divided them into living organ donation group (n=113) and the donation after citizen′s death group (n=141) according to the type of kidney donor. Sex, age, height, preoperative body weight, serum creatinine values before surgery and on the 3rd day, 7th day, 1 month, 2 months and 12 months after surgery, as well as postoperative hospital stay of the two groups were collected. The incidence of complications such as acute rejection, delayed graft function (DGF) and pulmonary infection and the survival of the recipient/graft were observed in both groups after kidney transplantation. The measurement data of normal distribution were compared by independent sample t test. The measurement data of non-normal distribution were compared by Mann-Whitney U test. The statistical data were compared by chi-square test or Fisher′s exact probability method. The postoperative survival curves of donation after citizen′s death group and living organ donation group were drawn by Kaplan-Meier method and compared by log-rank test. A P<0.05 was considered statistically significant.

Age, preoperative dialysis time, postoperative hospital stay, and serum creatinine at 3rd day, 7th day, 1 month and 2 months in living organ donation group were (32±8) years, 48(42, 56)months, 21 (22, 25) d, and (195±121), (135±73), (113±53) and (115±49) μmol/L, respectively, and (42±10) years, 8(15, 25) months, 23(30, 45) d, and (483±326), (333±267), (208±160) and (172±138) μmol/L in the donation after citizen′s death group, and the difference were statistically significant (t=88.552, -7.844, -7.055, -6.129 and -2.139, Z=-7.002 and -2.810, all P<0.05). The incidence of perioperative DGF, postoperative lung infection and acute rejection in the donation after citizen′s death group and living organ donation group were 29.1% (41/141) and 4.4% (5/113), 23.4% (33/141) and 3.5% (4/113), 14.9% (21/141) and 8.0% (9/113), respectively, and the differences were statistically significant (χ²=25.707, 19.889 and 4.637, all P<0.05). As of July 31, 2020, the average follow-up time for the living organ donation group was (30±7) months, and for the donation after citizen′s death group was (25±11) months. The transplanted kidney loss rate in the donation after citizen′s death was 11.3% (16/141), and living organ donation group was 0, and the difference was statistically significant (χ²=13.685, P<0.05). The cumulative survival rate of recipients at 42 months after transplantation in the donation after citizen′s death group was 86.3%, and the living organ donation group was 96.5%, and the difference was statistically significant (χ²=6.87, P<0.05).

Donation after donation after citizen′s death is currently the main source of donor kidneys, but its short-term clinical effect after surgery is worse than that of living organ donation kidney transplantation. The clinical effect of donation after citizen′s death kidney transplantation should be improved in terms of improving the quality of the donor kidney, reducing renal ischemia and reperfusion injury, and rigorously selecting recipients.