Increasing Use of the Expanded Criteria for Living Kidney Donation and Good Outcomes of Living Kidney Donors in Korea

Lim, Hyouk Jae; Jambaldorj, Enkthuya; Lee, Yong-Gu; Kang, Shin‐Sung; Koo, Tai Yeon; Ahn, Curie; Yang, Jaeseok

doi:10.1016/j.transproceed.2016.02.091

Cited by 10 publications

(8 citation statements)

References 17 publications

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“…[19] The progressively increasing imbalance between donors and recipients has urged to expand the donor pool, both enrolling marginal living donors and adopting techniques to recondition marginal cadaveric grafts. [20,21] LDKT is crucial for the future sustainability of kidney transplantation programs, as it both allows to relieve transplant waiting lists and grants superior outcomes for the recipients, especially in terms of reduced DGF rates. [22,23] Although the rate of living donation is constantly increasing, its proportion remains small compared to the size of waiting lists.…”

Section: Discussionmentioning

confidence: 99%

Renal vessel extension with cryopreserved vascular grafts: overcoming surgical pitfalls in living donor kidney transplant

Fallani

Maroni

Bonatti

et al. 2022

Preprint

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Background: LDKT is crucial to unburden waiting lists for renal transplant. Although the choice of the graft should be based on “leaving the better kidney to the donor”, right kidneys and kidneys with anomalous vascularization are often deferred because of concerns on complications and vascular reconstructions. To date, only few reports have examined renal vessel extension with cryopreserved vascular grafts in LDKT. The aim of this study is to investigate the effect of renal vessel extension on short-term outcomes and ischemia times in LDKT, especially in recipients of right kidney grafts or grafts with multiple vessels.Methods: From 2012 to 2020, recipients of LDKT with renal vessels extension through cryopreserved vascular grafts were compared with recipients of LDKT with no vascular lengthening. The primary endpoints were perioperative complications and DGF; secondary endpoints were warm and cold ischemia times.Results: Recipients of LDKT with (n=54) and without (n=91) vascular extension experienced similar hospital stays, surgical complications and DGF rates. For grafts with multiple vessels, renal vessel extension granted a faster implantation time (44±5 vs. 72±14 minutes), which resulted comparable to that of standard anatomy grafts. Right kidney grafts with vascular extension had a faster implantation time compared to right kidney grafts without vascular lengthening (43±5 vs. 58±9 minutes), and a comparable implantation time to left kidney grafts. Renal vascular extension resulted protective from prolonged implantation time.Conclusions: Renal vessel extension with cryopreserved vascular grafts allows a faster implantation time in right kidney grafts or grafts with anomalous vascularization, maintaining similar short-term surgical and functional outcomes.

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Section: Discussionmentioning

confidence: 99%

Renal vessel extension with cryopreserved vascular grafts: overcoming surgical pitfalls in living donor kidney transplant

Fallani

Maroni

Bonatti

et al. 2022

Preprint

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“…8,9 La donación cadavérica continúa constituyendo un reto en México, existe un mayor número de donantes, pero no los suficientes para satisfacer la demanda; esta institución realiza hasta 20% de trasplantes de origen cadavérico. Un aspecto relevante en la negativa para donar es la creencia religiosa, causas personales del paciente y del entorno familiar; aunque también la procuración de órganos exige personal capacitado para llevar a cabo este proceso hospitalario; [10][11][12] al respecto, el IMSS ha implementado la figura de Coordinador Hospitalario de Trasplantes, con resultados alentadores. 13 México debe continuar realizando estrategias para mejorar la donación de órganos.…”

Section: Materials Y Métodosunclassified

Comportamiento de la referencia a trasplante renal en el Instituto Mexicano del Seguro Social

Méndez-Durán¹

2020

Revista Mexicana De Trasplantes

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Introduction: The substitute therapies of the renal function constitute a support of life, nevertheless they are temporary treatments until realizing renal transplantation (TR), meanwhile the complications are present the deterioration of the quality and reduction of the life expectancy. The TR rehabilitates, gives the possibility of a normal life, family, social and labor reintegration. The reference to TR day by day becomes more frequent and knowing the behavior will allow to implement improvement strategies. Material and methods: Retrospective and cross-sectional study conducted from 2014 to 2019, includes data on references to TR generated by the general and regional hospitals of the IMSS of subjects up to 65 years of age. Reference location is identified, gender, age, cause of chronic renal failure (CRF), modality of replacement therapy. Results: 19,979 patients were referred, 12,386 were male (62%) and 7,593 female (38%), aged 1 to 65 years, the group of 20 to 29 years was the most prevalent (30%). The highest number of references received peritoneal dialysis 9,166 (46%), hemodialysis 8,981 (45%), and 1,832 (9%) pre-dialysis. The reference increased 8.7% annual average in all the dialysis modalities. Conclusions: The reference presents a continuous increase and pre-dialysis patients each year are referred in greater numbers. The demand for renal transplantation exceeds the needs of the institution and offers a large area of opportunity to favor a greater number of patients.

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“…It is essential that a donated kidney is functionally adequate, and also that the selected MD's kidney function and health condition is not affected after the donation in the long‐term. The definition of marginal criteria differs by reports; however, several reports have indicated the usefulness and safety of kidney donation from MDs 8,9 . In contrast, there are reports that kidney donations from MD may result in worse long‐term outcomes than from standard donor (SD) for both the recipients and donors, underscoring the need for careful selection 10–12 …”

Section: Introductionmentioning

confidence: 99%

“…The definition of marginal criteria differs by reports; however, several reports have indicated the usefulness and safety of kidney donation from MDs. 8 , 9 In contrast, there are reports that kidney donations from MD may result in worse long‐term outcomes than from standard donor (SD) for both the recipients and donors, underscoring the need for careful selection. 10 , 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Feasible kidney donation with living marginal donors, including diabetes mellitus

Yoshinaga

Araki

Wada

et al. 2021

Immunity Inflam & Disease

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Objectives To compare the donor outcomes of living donor kidney transplantation between standard donors (SDs) and marginal donors (MDs) including diabetic patients (MD + DM). Methods MDs were defined according to Japanese guideline criteria: (a) age >70‐years, (b) blood pressure ≤130/80 mmHg on hypertension medicine, (c) body mass index >25 to ≤32 kg/m2, (d) 24‐h creatinine clearance ≥70 to <80 ml/min/1.73 m2, and (e) hemoglobin A1c > 6.2 or ≤6.5 with oral diabetic medicine. Fifty‐three of 114 donors were MDs. We compared donor kidney functions until 60 months postoperatively. Results No kidney function parameters were different between SDs and MDs. When comparing SD and MD + DM, MD + DM had a lower postoperative eGFR (48 vs. 41 (1 (month), p = .02), 49 vs. 40 (12, p < .01), 48 vs. 42 (24, p = .04), 47 vs. 38 (36, p = .01)) and the percentage of residual eGFR (SD vs. MD + DM: 63 vs. 57 (1 (month), p < .01), 63 vs. 57 (2, p < .01), 64 vs. 56 (12, p < .01), 63 vs. 57 (24, p < .01), 63 vs. 52 (36, p = .02)). However, when MD with a single risk factor of DM was compared to SD, the difference disappeared. Nine out of 12 (75%) MD + DM had ≥2 risk factors. Conclusions Although long‐term observation of donor kidney function is necessary, careful MD + DM selection had the potential to expand the donor pool.

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Increasing Use of the Expanded Criteria for Living Kidney Donation and Good Outcomes of Living Kidney Donors in Korea

Cited by 10 publications

References 17 publications

Renal vessel extension with cryopreserved vascular grafts: overcoming surgical pitfalls in living donor kidney transplant

Renal vessel extension with cryopreserved vascular grafts: overcoming surgical pitfalls in living donor kidney transplant

Comportamiento de la referencia a trasplante renal en el Instituto Mexicano del Seguro Social

Feasible kidney donation with living marginal donors, including diabetes mellitus

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