The improvement in survival of expanded criteria donor kidneys with transplantation era

Clinical Transplantation
Robert P CarrollRowan G Walker

Abstract

To compensate for the shortage of donor kidneys, use of expanded donor criteria (ECD) has been adopted by many transplant centres. Multiple criteria on which to score such kidneys have been proposed but the evidence base for the definitions is derived from retrospective and registry data only. We aimed to see if analysis of ECD in our population would indicate the need to change our donor selection process. Data on primary kidney transplants (minimum follow-up two yr) from 1989 to 2004 were reviewed (n = 635). The primary study endpoint was overall graft survival. Published ECD, including the United Network for Organ Sharing (UNOS) ECD criteria were assessed as potential prognostic variables, in a multivariable Cox proportional hazards model. Patients transplanted after 1996 had improved graft survival compared to those transplanted pre-1996 HR = 0.51 (0.35-0.76), p = 0.0001. Pre-1996 UNOS defined ECD kidneys had a markedly increased risk of graft failure compared to live donor kidneys HR = 3.52 (1.9-6.35), p < 0.001. Post-1996 ECD kidneys had similar prognosis compared to live donor kidneys HR 0.38 (0.1-1.59), p = 0.184. The observed improvement in graft survival was not explained by changes in donor source, cause of end stage...Continue Reading

References

Mar 3, 1998·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·H J WangK Solez
Feb 13, 1999·Kidney International·L C RacusenY Yamaguchi
May 18, 1999·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·F MoresoJ M Grinyó
Mar 7, 2000·Journal of the American Society of Nephrology : JASN·Surazee PrommoolPhilip F Halloran
May 16, 2000·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·E PokornáO Schück
Jun 26, 2001·Journal of the American Society of Nephrology : JASN·Johan W DE FijterLeendert C Paul
Apr 16, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Robert A MetzgerRobert M Merion
Jun 5, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Scott L NybergMark D Stegall
Jul 4, 2003·American Journal of Nephrology·Norberto PericoGiuseppe Remuzzi
Aug 6, 2005·Transplantation·Rosemary MastersonGavin Becker
Dec 8, 2005·JAMA : the Journal of the American Medical Association·Robert M MerionFriedrich K Port
Feb 24, 2006·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Jose-Marie El-AmmErrol D Crook

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Citations

Jan 13, 2016·Transplant International : Official Journal of the European Society for Organ Transplantation·Anne-Hélène QuerardFlorence Gillaizeau
Oct 28, 2009·Transplantation Proceedings·P DomagalaA Chmura
Mar 17, 2015·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·C J WangB L Kasiske
Feb 22, 2014·Clinical Journal of the American Society of Nephrology : CJASN·Bertram L KasiskeFrancis L Delmonico
Mar 25, 2009·Current Opinion in Organ Transplantation

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