Current System for Allocation of Deceased Donor Kidney Transplantation

Kim, Mina; Kim, Seirhan; Lee, Su Hyung; Oh, Chang‐Keun; Bang, Jun Bae

doi:10.4285/jkstn.2017.31.3.143

Cited by 1 publication

(1 citation statement)

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“…KT has obvious benefits of survival gain and improved quality of life for older patients with ESRD. However, especially in countries with severe organ shortages like Korea [21], several years of waiting for an available deceased donor kidney contributes to waiting list mortality in older adults [22,23]. Accordingly, a number of researchers have suggested that LDKT be considered not only for younger patients but also for older ESRD patients because of its ability to improve survival [2,22,24,25].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of ABO‐incompatible kidney transplantation in older patients: a national cohort study

et al. 2020

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Background Outcomes of ABO‐incompatible living donor kidney transplantation (ABOi LDKT) in older individuals have not been established. Methods This multicentric observational study, using data from the Korean Organ Transplantation Registry database, included 634 older patients (≥60 years) undergoing kidney transplantation. We compared clinical outcomes of ABOi LDKT (n = 80) with those of ABO‐compatible LDKT (ABOc LDKT, n = 222) and deceased donor kidney transplantation (DDKT, n = 332) in older patients. Results Death‐censored graft survival was similar between the three groups (P = 0.141). Patient survival after ABOi LDKT was similar to that after ABOc LDKT (P = 0.489) but higher than that after DDKT (P = 0.038). In multivariable analysis, ABOi LDKT was not risk factor (hazard ratio [HR] 1.73, 95% confidence interval [CI] 0.29‐10.38, P = 0.548), while DDKT was significant risk factor (HR 3.49, 95% CI 1.01–12.23, P = 0.049) for patient survival. Although ABOi LDKT showed higher biopsy‐proven acute rejection than ABOc LDKT, the difference was not significant after adjustment with covariates. However, ABOi LDKT was significant risk factor for infection (HR 1.66, 95% CI 1.12–2.45, P = 0.012). Conclusions In older patients, ABOi LDKT was not inferior to ABOc LDKT and was superior to DDKT for patient survival. ABOi LDKT can be recommended for older patients, rather than waiting for DDKT.

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Section: Discussionmentioning

confidence: 99%