Living vs. Deceased Donor Kidney Transplantation Outcomes

Abstract

Introduction: Living donor kidney transplantation (LDKT) offers superior outcomes but remains underutilized. Methods: Meta-analysis of 20 cohort studies comparing graft survival, rejection, and patient survival between LDKT and deceased donor transplantation (DDKT). Results: LDKT had 50% lower risk of graft failure at 10 years (HR 0.5, p<0.001) and 40% lower mortality. Acute rejection rates were similar (15% vs. 18%). Preemptive LDKT (before dialysis) yielded best outcomes. Discussion: Shorter cold ischemia time, better HLA matching, and absence of brain death physiology explain LDKT advantage. Conclusion: LDKT should be encouraged through educational and financial support programs.