Comparison of first and second kidney transplants from the same deceased donor

Giessing, Markus; Fuller, T. Florian; Friedersdorff, Frank; Değer, Serdar; Schmidt, Danilo; Neumayer, H.-H.; Budde, Klemens; Liefeldt, Lutz

doi:10.1093/ndt/gfq338

Cited by 21 publications

(19 citation statements)

References 26 publications

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“…In agreement with Giessing et al, we did not find a negative impact of prolonged cold ischemia time in successively transplanted kidneys from the same donor [18]. On the other hand, results from the largest ESP study published so far indicate that each hour of prolonged cold ischemia increases the probability of graft loss by 3% [6].…”

Section: Discussionsupporting

confidence: 93%

Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program (ESP): A Single-Center Experience from 2008 to 2013

et al. 2016

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Background:The aim of this study was to evaluate the outcome after transplantation of deceased allografts in donor/recipient pairs aged ³65 years enrolled in the Eurotransplant Senior Program (ESP). Material/Methods:In this retrospective cohort study we evaluated data from 89 patients transplanted under the ESP protocol from 2008 to 2013. Outcome parameters included graft and patient survival, rate of biopsy-proven acute rejections (BPAR), peri-and post-operative complications, tumor development, development of donor-specific antibodies (DSA), and the prognostic role of preimplantation biopsies. Results:One-year patient and allograft survival rates were 92.1% and 84.3%, respectively. During follow-up, 23 (26%) patients died; the major cause of death was sepsis, followed by cardiovascular events and malignancies. BPAR episodes were frequent within the first year (~33%) and overall were less common in patients treated with tacrolimus. Post-transplant malignancies were seen in 15 (17%) patients. During follow-up, 16 (18%) patients developed DSA; patients with delayed graft function (DGF) were more likely to develop DSA (p=0.029). A higher preimplantation biopsy score was associated with DGF but did not predict later graft outcome. Conclusions:The results highlight increased risks in ESP transplant candidates and the importance of careful surveillance of this patient group.

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Section: Discussionsupporting

confidence: 93%

Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program (ESP): A Single-Center Experience from 2008 to 2013

et al. 2016

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“…Acute rejection was not associated with CIT in our study. These findings are in accordance with the findings of some studies (9,12), but not in others (11,14). Giblin et al (14) found acute rejection rates to be significantly lower for first kidneys compared to second kidneys transplanted ( (27) reported that DGF solely due to ischemia (in the absence of rejection) correlates strongly with the presence of fibrosis in the renal allograft at 3 months posttransplant.…”

Section: Discussionsupporting

confidence: 86%

Influence of CIT-Induced DGF on Kidney Transplant Outcomes

Kayler

Srinivas

Schold

2011

American Journal of Transplantation

130

107

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Increased cold ischemia time (CIT) predisposes to delayed graft function (DGF). DGF is considered a risk 18 164 recipients) were analyzed. The adjusted odds (aOR) of DGF were significantly higher when CIT was longer by ≥1 h (aOR 1.81, 95% CI 1.7-2.0), ≥5 h (aOR 2.5, 95% CI 2.3-2.9), ≥10 h (aOR 3.3, 95% CI 2.7-2.9) and ≥15 h (aOR 4.4, 95% CI 3.4-5.8) compared to shorter CIT transplants. In the multivariable models adjusted for recipient characteristics, graft survival between paired donor transplants, with and without DGF, were similar. These results suggest that DGF, specifically induced by prolonged CIT, has limited bearing on long-term outcomes, which may have important implications for kidney utilization.

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“…[10] reported similar values: donor age of 51 years and a DGF rate of 31%. In a previous study from our institution, the incidence of DGF among deceased donor renal transplant recipients reached 40% with a median donor age of 58.5 years [11].…”

Section: Discussionmentioning

confidence: 76%

Impact of surgeon experience on complication rates and functional outcomes of 484 deceased donor renal transplants: a single‐centre retrospective study

Cash¹,

Slowinski

Buechler³

et al. 2012

BJU International

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Comparison of first and second kidney transplants from the same deceased donor

Abstract: We found no difference between the successively transplanted kidneys of the same donor, not even for the expanded criteria donor organs. Nevertheless, assuming a 'safe' CIT is not justified, and CIT should always be kept as short as possible.

Cited by 21 publications

References 26 publications

Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program (ESP): A Single-Center Experience from 2008 to 2013

Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program (ESP): A Single-Center Experience from 2008 to 2013

Influence of CIT-Induced DGF on Kidney Transplant Outcomes

Impact of surgeon experience on complication rates and functional outcomes of 484 deceased donor renal transplants: a single‐centre retrospective study

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