Comparison of Cadaveric Kidney Transplantation From In-center and External Center Donors

Abstract Introduction Renal transplantation is the best treatment modality for end-stage renal disease. We investigated the effects of donor source on renal allograft and patient survival in deceased donor transplants. Methods We analyzed retrospectively 190 cadaver kidney transplants performed in o...

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Published in:	Transplantation proceedings Vol. 46; no. 10; pp. 3396 - 3399
Main Authors:	Cho, A.J, Jang, H.R, Lee, J.E, Huh, W.S, Kim, Y.-G, Oh, H.Y, Kim, D.J
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-12-2014
Subjects:	Adult Female Graft Survival - immunology Humans Kidney Failure, Chronic Kidney Transplantation - mortality Male Middle Aged Proportional Hazards Models Renal Dialysis Retrospective Studies Surgery Tissue and Organ Harvesting
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Summary:	Abstract Introduction Renal transplantation is the best treatment modality for end-stage renal disease. We investigated the effects of donor source on renal allograft and patient survival in deceased donor transplants. Methods We analyzed retrospectively 190 cadaver kidney transplants performed in our center from January 2000 to December 2009. Of these, 136 kidneys were harvested in our transplantation center and 54 were from external donors. Primary outcome of graft survival was assessed with the Kaplan–Meier method and the significance of possible variables was determined with the Cox proportional hazard model. Results There was no difference between groups in the age of donor and recipient, recipient body mass index, duration of dialysis, or panel reactive antibody >30%. Twenty recipients lost their grafts (14 from external donors and 6 from internal donors). Graft survival at 1, 3, and 5 years was 99.2%, 97.3%, and 95.5% for in-center donors and 98.1%, 88.9%, and 86.2% for external donor transplants ( P = .01). There was no difference in patient survival rates between the groups. Acute rejection episodes (hazard ratio [HR], 13.2; P < .001) and external hospital donor (HR, 9.3; P = .008) were independent factors associated with failure. Higher age of recipient was associated with increased patient death rate (HR, 1.2; P = .02). Conclusion Graft survival of cadaveric transplants from in-center donors was better than that of transplants from external center donors. Acute rejection episodes and location of harvest were significant factors for graft survival. Further study is needed to evaluate the effects of center-level factors on allograft outcomes.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0041-1345 1873-2623
DOI:	10.1016/j.transproceed.2014.04.015