OUTCOMES Living Unrelated Versus Living Related Kidney Transplantation: 20 Years’ Experience With 2155 Cases N. Simforoosh, A. Basiri, M.R. Fattahi, B. Einollahi, A. Firouzan, F. Pour-Reza-Gholi, M. Nafar, and F. Farrokhi ABSTRACT Purpose. To compare the long-term results of kidney transplantation from living unrelated donors (LURDs) with that from living related donors (LRDs). Materials and methods. From 1984 to 2004, we performed 2155 kidney transplantations of which 374 were from LRDs and 1760 from LURDs. We reviewed and compared the long-term data from these cases. Results. The LURD group included 64.2% men with an overall mean age of 33.46  14.61 (range 3 to 76) years. Laparoscopic donor nephrectomy was performed in 329 cases (18.7%) with mean follow-up of 45.68  46.80 months. The LRD group included 66.5% of male recipients with overall mean age of 28.97  9.58 (range 9 to 65) years. Laparoscopic donor nephrectomy was performed in 12 cases (3.2%) of LRDs with mean follow-up of 81.15  67.03 months. One-, 3-, 5-, 10-, and 15-year graft survivals among LRDs were 91.6%, 81.7%, 76.4%, 64.4%, and 48.4%; and for LURDs, 91.5%, 86.7%, 81.4%, 68.2%, and 53.2%, respectively (P = .07). Patient survivals for 1, 3, 5, 10, and 15 years in LRDs were 94.6%, 91.9%, 83%, 79.5%, and 73.9%, and in LURDs were 93.6%, 91.7%, 89.3%, 84%, and 76.4%, respectively (P = .14). Conclusion. The results of living unrelated kidney transplantation upon long-term follow-up with a large number of cases were as good as living related kidney transplanta- tion. The organ shortage can be alleviated by using living unrelated kidney transplantation. To our knowledge this is the largest experience with long-term follow-up reported from one center to date. R ENAL TRANSPLANTATION is the procedure of choice for most patients with end-stage renal disease (ESRD), since it improves the quality of life and is cost- effective compared with dialysis. 1,2 The rapidly increasing incidence of renal failure and the inadequate supply of kidneys, especially from cadavers, have created a wide gap between kidney supply and demand, which has resulted in long waiting times as well as an increasing number of deaths during the dialysis-dependency period. 3 We performed the first planned living unrelated donor (LURD) program in Iran and the Middle East in 1984. 3 We have expanded our donor pool by performing renal transplants from genetically unrelated donors. This article describes our experience with living unrelated renal transplants (LURTs), which we believe to be is the largest experience at a single center in the world. MATERIALS AND METHODS From 1984 to July 2004, 2155 kidney transplantations were per- formed at our center. Transplantation from LURDs started in 1984 From the Department of Kidney Transplantation, Shaheed Labbafinejad Medical Center, Urology and Nephrology Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. Address reprint requests to Nasser Simforoosh, MD, Shahid Labbafi Nejad Hospital, 9th Boustan, Pasdaran Ave, Tehran, IR Iran, 1666679951. E-mail: simforoosh@iurtc.org.ir 0041-1345/06/$–see front matter © 2006 by Elsevier Inc. All rights reserved. doi:10.1016/j.transproceed.2006.01.012 360 Park Avenue South, New York, NY 10010-1710 422 Transplantation Proceedings, 38, 422– 425 (2006)