Outcome of Transplantation in Renal Allograft Recipients From Cadaveric Donors With Standard and Expanded Criteria: A Single-Center Experience

• Published in: Transplantation proceedings Vol. 46; no. 9; pp. 3172 - 3174
• Main Authors: Papachristou, E, Provatopoulou, S, Savvidaki, E, Kaplanis, N, Kalliakmani, P, Papasotiriou, M, Fyssa, L, Tsamantas, A, Fokaefs, E, Marangos, M, Mira, N, Maroulis, I, Karavias, D, Goumenos, D.S, Vlachogajannis, J
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2014
• Subjects: Adolescent; Adult; Aged; Cadaver; Child; Female; Follow-Up Studies; Graft Survival; Greece - epidemiology; Hospitals, University; Humans; Kidney Transplantation - methods; Male; Middle Aged; Retrospective Studies; Surgery; Survival Rate - trends; Time Factors; Tissue Donors - supply & distribution; Transplantation, Homologous; Treatment Outcome; Young Adult; Greece
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2014.10.030

Abstract Introduction The increasing number of patients requiring kidney transplantation and the lack of available organs has led to the utilization of kidneys from expanded criteria donors (ECD). Aim The comparison of the clinical outcome of renal transplantation, performed in a single center, between allograft recipients from standard (SCD) and expanded criteria donors (ECD). Patients and Methods Data from 215 cadaveric renal transplantations performed during a 16 year period at the University Hospital of Patras were retrospectively studied. Donors' and recipients' characteristics (gender, age, history of hypertension and diabetes mellitus, cold ischemia time, post-transplant and long term graft function) were analyzed. Results Grafts from donors with expanded criteria (ECD, n = 53) were allocated to older recipients whereas grafts from donors with standard criteria (SCD, n = 162) were allocated to younger recipients. The mean cold ischemia time was 1,146 min and was similar between the two groups of patients. Patients' survival rates were similar between allograft recipients from SCD and ECD up to the 5th post-transplant year of follow-up. Graft survival was significantly better in allograft recipients from SCD during a 5-year follow-up period. A significantly lower eGFR was noted in allograft recipients from ECD in comparison to those from SCD throughout the observation period. Cold ischemia time was positively correlated to the development of DGF, while patients with DGF had significantly worse graft function throughout the observation period. Conclusion Patient survival from ECD is comparable to that from SCD but graft survival is significantly lower. However, since renal function of recipients from ECD is adequate for long term period, grafts from ECD should be used in older patients.