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
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TLDR
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.Abstract:
. An increasing number of cadaveric kidney transplants are now performed with organs from donors who would have been deemed unsuitable in earlier times. Although good allograft outcomes have been obtained with these marginal donor transplants, it is unclear whether recipients of marginal kidney transplants achieve a reduction in long-term mortality as do recipients of “ideal” kidneys. Patients with end-stage renal disease registered on the cadaveric renal transplant waiting list between January 1, 1992, and June 30, 1997, were studied for mortality risks according to three outcomes: wait-listed on dialysis treatment with no transplant (WLD); transplantation with marginal donor kidney (MDK); and “ideal” or optimal donor kidney transplantation (IDK). Thirty-four percent of wait-list registrants had received a cadaveric kidney transplant by June 30, 1998. Of these, 18% received a marginal kidney that had one or more of the following pretransplant factors: donor age >55 yr, non-heartbeating donor, cold ischemia time >36 h, and donor hypertension or diabetes mellitus of > 10 yr duration. Five-year graft and patient survival was 53% and 74% for MDK recipients compared with 67% ( P Pread more
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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
Deceased-donor characteristics and the survival benefit of kidney transplantation.
Robert M. Merion,Valarie B. Ashby,Robert A. Wolfe,Dale A. Distant,Tempie E. Hulbert-Shearon,Robert A. Metzger,Akinlolu O. Ojo,Friedrich K. Port +7 more
TL;DR: ECD kidney transplants should be offered principally to candidates older than 40 years in OPOs with long waiting times, and candidates should be counseled that ECD survival benefit is observed only for patients with diabetes.
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
Survival Benefit of Solid-Organ Transplant in the United States
Abbas Rana,Angelika C. Gruessner,Vatche G. Agopian,Zain Khalpey,Irbaz Bin Riaz,Bruce Kaplan,Karim J. Halazun,Ronald W. Busuttil,Rainer W.G. Gruessner +8 more
TL;DR: It is demonstrated that more than 2 million life-years were saved to date by solid-organ transplants during a 25-year study period.
Journal ArticleDOI
Canadian Society of Transplantation: consensus guidelines on eligibility for kidney transplantation.
Greg Knoll,Sandra Cockfield,Tom Blydt-Hansen,Dana Baran,Bryce A. Kiberd,David Landsberg,David N. Rush,Edward S. Cole +7 more
TL;DR: The number of new patients with the disease increased at a compound annual rate of 7.3% from 1981 to 1999, and similar trends have been documented worldwide.
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
The Quality of Life of Patients with End-Stage Renal Disease
Roger W. Evans,Manninen Dl,Garrison Lp,Hart Lg,Christopher R. Blagg,Gutman Ra,Hull Ar,Lowrie Eg +7 more
TL;DR: The quality of life of transplant recipients compared well with that of the general population, but despite favorable subjective assessments, patients undergoing dialysis did not work or function at the same level as people in the generalpopulation.
Journal ArticleDOI
A study of the quality of life and cost-utility of renal transplantation
Andreas Laupacis,Paul Keown,Nancy Pus,Hans Krueger,Beryl Ferguson,Cynthia J. Wong,Norman Muirhead +6 more
TL;DR: It is concluded that renal transplantation was more effective and less costly than dialysis in all subgroups of patients examined, including patients older than 60 and diabetics.
Journal ArticleDOI
Comparison of Survival Probabilities for Dialysis Patients vs Cadaveric Renal Transplant Recipients
TL;DR: The overall mortality risk following renal transplantation was initially increased, but there was a long-term survival benefit compared with similar patients on dialysis.
Journal ArticleDOI
The Effect of Patients' Preferences on Racial Differences in Access to Renal Transplantation
TL;DR: racial differences remained significant after adjustment for patients' preferences and expectations about transplantation, sociodemographic characteristics, the type of dialysis facility, perceptions of care, health status, the cause of renal failure, and the presence or absence of coexisting illnesses.