1
|
Khan MA, El-Hennawy H, Farney AC, Rogers J, Orlando G, Reeves-Daniel A, Palanisamy A, Gautreaux M, Iskandar S, Doares W, Kaczmorski S, Stratta RJ. Analysis of local versus imported expanded criteria donor kidneys: A single-center experience with 497 ECD kidney transplants. Clin Transplant 2017; 31. [PMID: 28612360 DOI: 10.1111/ctr.13029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND The value of importing expanded criteria donor (ECD) kidneys is uncertain. METHODS We retrospectively reviewed our single-center experience with ECD kidney transplants (KT). RESULTS Over 12.8 years, we performed 497 ECD KTs including 247 local and 250 imported from other donor service areas. The import ECD group had more donors (16% vs 9%) ≥ age 70, more zero human leukocyte antigen mismatches (14% vs 2%), more KTs with a cold ischemia time >30 hours (46% vs 19%), and fewer kidneys managed with pump preservation (78% vs 92%, all P≤.05) compared to the local ECD group. Mean Kidney Donor Profile Index were 80% import vs 84% local. With a mean follow-up of 55 months, actual patient and graft survival rates were 71% and 58% in import vs 76% and 58% in local ECD KTs, respectively. Death-censored graft survival rates were 70% in import vs 69% in local ECD KTs. Delayed graft function occurred in 28% import vs 23% local ECD KTs (P=NS) whereas the incidence of primary nonfunction was slightly higher with import ECD kidneys (4.8% vs 2.4%, P=.23). CONCLUSIONS Midterm outcomes are remarkably similar for import vs local ECD KTs, suggesting that broader sharing of ECD kidneys may improve utilization without compromising outcomes.
Collapse
Affiliation(s)
- Muhammad A Khan
- Department of Surgery, Section of Transplantation, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hany El-Hennawy
- Department of Surgery, Section of Transplantation, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Alan C Farney
- Department of Surgery, Section of Transplantation, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jeffrey Rogers
- Department of Surgery, Section of Transplantation, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Giuseppe Orlando
- Department of Surgery, Section of Transplantation, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Amber Reeves-Daniel
- Department of Internal Medicine, Section of Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Amudha Palanisamy
- Department of Internal Medicine, Section of Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Michael Gautreaux
- Department of Pathology, Section of Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Samy Iskandar
- Department of Pathology, Section of Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - William Doares
- Department of Pharmacy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Scott Kaczmorski
- Department of Pharmacy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Robert J Stratta
- Department of Surgery, Section of Transplantation, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|