Early and Long-Term Outcomes of Kidney Grafts Procured From Multiple-Organ Donors and Kidney-Only Donors

Cholewa, Hanna; Chronowska, Justyna; Kukla, Urszula; Goc, T.; Lieber, Ewelina; Kolonko, Aureliusz; Budziński, G.; Ziaja, Jacek; Wiȩcek, Andrzej; Cierpka, Lech

doi:10.1016/j.transproceed.2015.11.041

Cited by 1 publication

(3 citation statements)

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“…18 However, this and other studies suggest that although grafts obtained from KO donors are associated with statistically slightly inferior graft survival and a higher incidence of DGF, they actually perform quite well and only make up a small portion of transplantable organs available for the ever-expanding waiting list. [5][6][7]19 The major strength of this study is the use of propensity score matching to allow for comparison of KO donor recipients to a well-matched cohort of recipients of kidneys from MO donors. The weakness of this study is its retrospective nature.…”

Section: Discussionmentioning

confidence: 99%

“…Procuring multiple organs from a single donor requires a more complex and longer operation than when procuring kidneys alone. 5 On the other hand, preoperative donor health status is a key driver in determining which organs will be procured at the time of organ donation, and many studies have demonstrated that kidney-only (KO) donors tend to be older and have a higher burden of medical comorbidities. 6,7 Despite the differences that exist between multiple-organ (MO) donors and KO donors, current scoring systems do not factor the number of organs procured when trying to predict graft function of a transplanted kidney.…”

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confidence: 99%

“…2 Multiple single-center studies have demonstrated inferior outcomes in grafts from KO deceased donors when compared with those donated by MO donors. 5,6 This difference is suspected to be due to overall poor donor status and higher burden of comorbidities in KO donors. This study was undertaken to expand on these findings and assess whether renal transplant outcomes differ after donation by KO versus MO donors on a national scale.…”

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Nationwide Outcomes after Renal Transplantation from Kidney-Only versus Multiple-Organ Deceased Donors

Katsaros

Schucht

Jones

et al. 2019

The American Surgeon

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To assess renal transplant outcomes after donation by kidney-only (KO) versus multiple-organ (MO) donors on a national scale. The United Network for Organ Sharing database was examined for patients undergoing isolated kidney transplant from a deceased donor from 2000 through 2016. Comparison was made between recipients of grafts from KO versus MO donors at baseline and in a cohort of KO and MO recipients matched via propensity scoring. Outcomes of interest included delayed graft function (DGF), patient survival, and the cumulative incidence of graft loss. There were 33,326 recipients in the KO cohort versus 144,690 in the MO cohort. Donation after cardiac death donors were more prevalent in the KO group (43.8% vs 5.3%; P < 0.001). DGF occurred in 36.1 per cent of the KO versus 22.7 per cent of the MO recipients ( P < 0.001). Five-year survival was 79.5 per cent versus 83.4 per cent ( P < 0.001) in the KO versus MO group. After propensity matching, DGF was still more common in the KO group (33.1% vs 30.1%; P < 0.001). Patient survival was similar (79.5% KO vs 80.1% MO; P = 0.117). Cumulative incidence of graft loss was higher in the KO group (17.8% vs 16.8%). Survival outcomes from KO donors are actually quite good and should not be considered as inferior to MO donors.

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Section: Discussionmentioning

confidence: 99%

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