Increased Kidney Transplantation Utilizing Expanded Criteria Deceased Organ Donors with Results Comparable to Standard Criteria Donor Transplant
Robert J. Stratta,Michael S. Rohr,Aimee K. Sundberg,Gregory T Armstrong,Gloria Hairston,Erica L. Hartmann,Alan C. Farney,Julie Roskopf,Samy S. Iskandar,Patricia L. Adams +9 more
TLDR
The use of ECD kidneys at the authors' center effectively doubled their transplant volume within 1 year, and a systematic approach to E CD kidneys based on nephron mass matching and nephrons sparing measures may provide optimal utilization with short-term outcomes and renal function comparable to SCD kidneys.Abstract:
Objective:To compare outcomes in recipients of expanded criteria donor (ECD) versus standard criteria donor (SCD) kidneys at a single center using a standardized approach with similar immunosuppression.Summary Background Data:Expanded criteria deceased organ donors (ECD) are a source of kidneys thatread more
Citations
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A risk prediction model for delayed graft function in the current era of deceased donor renal transplantation.
TL;DR: A model for predicting DGF after renal transplantation was presented and the most significant factors associated with DGF were cold ischemia time, donor creatinine, body mass index, donation after cardiac death and donor age.
Journal ArticleDOI
Outcomes of kidneys from donors after cardiac death: implications for allocation and preservation.
Jayme E. Locke,Dorry L. Segev,Daniel S. Warren,Francesca Dominici,Christopher E. Simpkins,Robert A. Montgomery +5 more
TL;DR: It is suggested that DCD <50 kidneys function like SCD kidneys and should not be viewed as marginal or ECD, and further, limiting CIT <12 h markedly reduces DGF.
Journal ArticleDOI
The alphabet soup of kidney transplantation: SCD, DCD, ECD--fundamentals for the practicing nephrologist.
TL;DR: Familiarity with the comprehensive allocation rules governing different categories of deceased-donor kidneys by the nephrologists and dialysis team providers is essential to maximizing patient autonomy and to improve the outcomes of kidney transplantation.
Journal ArticleDOI
Outcome of Kidney Transplantation Using Expanded Criteria Donors and Donation After Cardiac Death Kidneys: Realities and Costs
Reza F. Saidi,Nahel Elias,Tatsuo Kawai,Martin Hertl,M L Farrell,Nelson Goes,Waichi Wong,Choli Hartono,Jay A. Fishman,Camille N. Kotton,Nina Tolkoff-Rubin,Francis L. Delmonico,Cosimi Ab,Dicken S.C. Ko +13 more
TL;DR: Although the observations support the utilization of ECD and DCD kidneys, these transplants are associated with increased costs and resource utilization and revised reimbursement guidelines will be required for centers that utilize these organs.
Journal ArticleDOI
Factors leading to the discard of deceased donor kidneys in the United States.
Sumit Mohan,Sumit Mohan,Mariana C. Chiles,Mariana C. Chiles,Rachel E. Patzer,Stephen O. Pastan,S. Ali Husain,S. Ali Husain,Dustin J. Carpenter,Geoffrey K. Dube,R. John Crew,Lloyd E. Ratner,David J. Cohen +12 more
TL;DR: There was considerable geographic variation in the odds of discard across the United States, which further supports the notion that factors beyond organ quality contributed to kidney discard.
References
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Journal ArticleDOI
Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric Transplant
Robert A. Wolfe,Valarie B. Ashby,Edgar L. Milford,Akinlolu O. Ojo,Robert E. Ettenger,Lawrence Y. Agodoa,Philip J. Held,Friedrich K. Port +7 more
TL;DR: In this paper, the authors conducted a longitudinal study of mortality in 228,552 patients who were receiving long-term dialysis for end-stage renal disease, and 46,164 were placed on a waiting list for transplantation, 23,275 of whom received a first cadaveric transplant between 1991 and 1997.
Journal ArticleDOI
Survival in Recipients of Marginal Cadaveric Donor Kidneys Compared with Other Recipients and Wait-Listed Transplant Candidates
Akinlolu O. Ojo,Julie A. Hanson,Herwig Ulf Meier-Kriesche,Chike Nathan Okechukwu,Robert A. Wolfe,Alan B. Leichtman,Lawrence Y. Agodoa,Bruce Kaplan,Friedrich K. Port +8 more
TL;DR: It is concluded that transplantation of a marginal kidney is associated with a significant survival benefit when compared with maintenance dialysis and the average increase in life expectancy for MDK recipients compared with the WLD cohort was 5 yr, although this benefit varied from 3 to 10 yr depending on the recipient's characteristics.
Journal ArticleDOI
Donor characteristics associated with reduced graft survival: an approach to expanding the pool of kidney donors.
Friedrich K. Port,Jennifer L. Bragg-Gresham,Robert A. Metzger,Dawn M. Dykstra,Brenda W. Gillespie,Eric W. Young,Francis L. Delmonico,James J. Wynn,Robert M. Merion,Robert A. Wolfe,Philip J. Held +10 more
TL;DR: By identifying donor factors associated with graft failure, these analyses may help to expand the number of transplanted kidneys by increasing the utilization of retrieved cadaveric kidneys.
Journal ArticleDOI
Expanded criteria donors for kidney transplantation.
Robert A. Metzger,Francis L. Delmonico,Sandy Feng,Friedrich K. Port,James J. Wynn,Robert M. Merion +5 more
TL;DR: A large number of patients with prior organ transplants are likely to have had at least one prior organ transplant, and the results suggest that the number of previous transplants may have an important role in determining the prognosis.
Journal ArticleDOI
The impact of body mass index on renal transplant outcomes: a significant independent risk factor for graft failure and patient death
TL;DR: BMI has a very strong association with outcomes after renal transplantation independent of most of the known risk factors for patient and graft survival and is important to note that elevated BMI was significantly associated with worse graft survival independent of patient survival.