Impact of donor type on short-term renal transplant outcomes in a tertiary center

Abstract

Kidney transplantation (KT) remains the definitive treatment for end-stage renal disease. This study aimed to assess and compare the outcomes of cadaveric(CD) and live donor (LD) renal transplantation at the Professorial Vascular and Transplant Surgical Unit, National Hospital, Colombo. A retrospective cohort study was carried out, analyzing KT done from January 2023 to July 2025. Data were collected from the theatre registry. A total of 57 KT was included, of which 38 were LD and 19 were CD. The mean follow-up was 334.84 days. The overall survival rate at two weeks post-transplant was 98.25% (LD/ CD - 100%/ 94.74% (p>0.05). The overall survival at one to six months post-transplant was 94.44%, 94.23%, 93.88%, 93.48%, 87.5%, and 86.11%, respectively. These survival rates for LD were 97.29%, 97.22%, 97.14%, 96.88%, 96.15%, and 95.45% and CD was 88.24%, 87.5%, 85.71%, 85.71%, 71.43%, and 71.43%. The six-month survival rates of LD vs CD nearly approached statistical significance (p=0.057) with a relative risk of death of 6.28 for CD recipients. A noticeable survival decline after 4 months was seen, predominantly among CD recipients. Cadaveric transplant recipients had a higher risk of mortality at six months compared to live donor recipients. Although not statistically significant, likely due to sample size, the clinical trend is clear. The decline in survival beyond four months in the CD group may be related to reduced follow-up and relaxation of post-transplant precautions.