Expanding the use of expanded criteria donors in kidney transplantation

Expanding the use of expanded criteria donors in kidney transplantation

Author Assis-Borba, Luciana Autor UNIFESP Google Scholar
Cristelli, Marina P. Autor UNIFESP Google Scholar
Paula, Mayara I. Autor UNIFESP Google Scholar
Franco, Marcelo F. Autor UNIFESP Google Scholar
Tedesco-Silva, Helio Autor UNIFESP Google Scholar
Medina-Pestana, Jose O. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Although the use of kidney allografts from expanded criteria donors (ECD) has increased in recent years, the reported discard rates are also growing. the influence of ECD characteristics on transplant outcomes is still underevaluated.This retrospective study investigated the influence of preimplantation biopsy findings and delayed graft function (DGF) on patient and graft survivals and renal function at 36 months in a cohort of 372 ECD kidney transplant recipients.Patient and graft survivals were 91.6 and 68.9 %. the incidence of biopsy-proven acute rejection was 31 %. There were no differences in patient (88.6 vs. 91.1 vs. 94.7 vs. 78.6 %, p = 0.10) or graft (78.1 vs. 72.2 vs. 60.5 vs. 62.6 %, p = 0.14) survivals and renal function (41.7 +/- A 25.6 vs. 39.9 +/- A 29.9 vs. 38.1 +/- A 30.6 vs. 37.4 +/- A 29.2 mL/min, p = 0.79) comparing ECD kidneys with mild, moderate, and severe histological changes or with no preimplantation biopsy, respectively. However, severe scored transplants had the worst death-censored graft survival (OR 3.1, 95 % CI 1.4-6.9, p = 0.007). No significant differences in patient (86.2 vs. 83.4 %, p = 0.17) or graft (73.7 vs. 65.9 %, p = 0.06) survivals and renal function (38.9 +/- A 28.6 vs. 39.9 +/- A 28.4 mL/min, p = 0.72) were observed comparing patients with or without DGF. Multivariable analysis found diabetes history as the only independent risk factor for graft loss (OR 2.1, 95 % CI 1.3-3.3, p = 0.003) or patient death (OR 3.1, 95 % CI 1.5-5.8, p < 0.001).Within the limitations of sample size and short follow-up time, in this cohort of ECD kidney transplant recipients the severity of histological changes observed in preimplantation biopsies was independently associated with graft loss.
Keywords Expanded criteria donors
Graft histology
Kidney transplantation
Survival
Language English
Date 2014-08-01
Published in International Urology and Nephrology. Dordrecht: Springer, v. 46, n. 8, p. 1663-1671, 2014.
ISSN 0301-1623 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 1663-1671
Origin http://dx.doi.org/10.1007/s11255-014-0695-0
Access rights Closed access
Type Article
Web of Science ID WOS:000340523800029
URI http://repositorio.unifesp.br/handle/11600/38036

Show full item record




File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account