Clinical and Histopathologic Comparative Analysis Between Kidney Transplant Recipients From Expanded-Criteria Donors and Standard-Criteria Donors

Clinical and Histopathologic Comparative Analysis Between Kidney Transplant Recipients From Expanded-Criteria Donors and Standard-Criteria Donors

Abstract Owing to the disparity between the supply of kidney donors and demand, the use of organs from older deceased donors was initiated in recent years. The potentially poor outcome of these grafts is a major concern. This retrospective study compares graft and patient 1-year survivals between re...

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Bibliographic Details
Published in:Transplantation proceedings Vol. 45; no. 9; pp. 3234 - 3238
Main Authors: Ramalho, A.L.A.S, Custodio, F.B, Tokuda, B.M, Caldas, H.C, Fernandes, I.M, Abbud-Filho, M, Baptista, M.A
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-11-2013
Subjects:
Adolescent
Adult
Child
Child, Preschool
Graft Survival
Humans
Kidney - pathology
Kidney Transplantation
Middle Aged
Retrospective Studies
Surgery
Tissue Donors
Young Adult
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Summary:Abstract Owing to the disparity between the supply of kidney donors and demand, the use of organs from older deceased donors was initiated in recent years. The potentially poor outcome of these grafts is a major concern. This retrospective study compares graft and patient 1-year survivals between recipients from expanded-criteria donors (ECD; n  = 30) and standard-criteria donors (SCD; n  = 104). Rates of delayed graft function (DGF), acute rejection (AR), and chronic injury in the pre-implantation biopsy were also assessed. Increasing donor age was associated with increased rates of DGF, and DGF correlated with AR. Cold ischemia time >30 hours was associated with worse graft outcomes. Induction with Simulect correlated with better patient survival compared with Timoglobulina. Chronic injury pre-implantation biopsy correlated with worse renal function, but graft survival was similar. Death-censored graft survival at 1 year was 90% and patient survival 82%, and these were similar in ECD and SCD recipients. Selection of transplant candidates for ECD kidneys must be performed with caution. One-year graft survival was similar to that of SCD kidneys, but kidney function was worse during the same period. This may result in poorer graft survival over longer follow-up.
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ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2013.05.004