TY - JOUR
TI - Optimal utilization of expanded criteria deceased donors for kidney transplantation
AU - Karatzas, T.
AU - Gompou, A.
AU - Bokos, J.
AU - Dimitroulis, D.
AU - Boletis, J.
AU - Kostakis, A.
AU - Kouraklis, G.
AU - Zavos, G.
JO - International Urology and Nephrology
PY - 2011
VL - 43
TODO - 4
SP - 1211-1219
PB - 
SN - 0301-1623
TODO - 10.1007/s11255-011-9930-0
TODO - basiliximab;  creatinine;  cyclosporin;  daclizumab;  mycophenolic acid 2 morpholinoethyl ester;  prednisone;  tacrolimus, acute graft rejection;  bleeding;  cadaver;  chronic allograft nephropathy;  chronic graft rejection;  cold ischemia;  controlled study;  creatinine blood level;  criterion variable;  diabetic nephropathy;  expanded criteria donors;  female;  glomerulonephritis;  graft survival;  human;  human tissue;  immunosuppressive treatment;  kidney failure;  kidney graft;  kidney graft rejection;  kidney polycystic disease;  kidney transplantation;  major clinical study;  male;  organ donor;  outcome assessment;  overall survival;  renal artery thrombosis;  retrospective study;  review;  vesicoureteral reflux;  age;  article;  delayed graft function;  donor;  graft rejection;  Greece;  length of stay;  register;  standard;  statistical analysis;  survival rate;  time;  transplantation, Actuarial Analysis;  Age Factors;  Delayed Graft Function;  Graft Rejection;  Graft Survival;  Greece;  Humans;  Kidney Transplantation;  Length of Stay;  Registries;  Retrospective Studies;  Survival Rate;  Time Factors;  Tissue and Organ Procurement;  Tissue Donors
TODO - Background The utilization of kidney grafts from expanded criteria donors (ECDs) needs to be evaluated within the context of critical organ shortage and graft function and survival. The impact of donor risk variables on kidney transplantation (KTx) outcome was investigated. Methods A retrospective review of 75 KTxs from ECDs over a 5-year period was performed. Donor risk factors were analyzed separately and correlated with recipients graft function and survival. Results Sixty-four recipients out of 75 (85.3%) had functioning grafts 5 years post-transplant. The overall actuarial graft survival rates at 1 through 5 years were 87.5, 68.1, 57.3, 55.4, and 47.3%, respectively. Forty-seven kidneys (62.7%) had early function with actuarial survival of 100.0, 88.3, 75.8, 75.8, and 68.4% at 1-5 years post-transplant, and 28 (37.3%) grafts presented delayed function with substantially decreased actuarial survival, ranging from 66.7 to 23.2%. KTxs from elderly donors had remarkable actuarial survival rates ranging from 100.0 to 67.0%, at 1-5 years, being the best graft survival rates among KTxs from other donor categories. The other donor risk variables when associated with old age had an adverse effect on recipient graft function and survival, but none alone or a combination of the two, showed any significant statistical variability. Conclusion ECDs significantly increased the kidney pool and can be utilized safely if adequate measures are taken. © 2011 Springer Science+Business Media, B.V.
ER -