Long-Term Outcomes of Kidney Transplantation From Expanded-Criteria Deceased Donors: A Single-Center Experience

Ferreira, E.; Costa, Joana; Romãozinho, Catarina; Santos, Lídia; Macário, Fernando; Bastos, C.; Alves, Rui; Figueiredo, Arnaldo

doi:10.1016/j.transproceed.2017.01.051

Cited by 12 publications

(14 citation statements)

References 21 publications

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“…Therefore, it appears that the main reason for graft loss in this group is patient mortality, even though they die with functioning grafts. Recently, Ferreira et al showed that transplantation with the use of expanded criteria deceased donors’ kidneys provide quite satisfactory patient and graft survival rates despite their poorer long‐term outcomes . As there are now more patients on the waiting list to receive a kidney‐after‐nonrenal organ transplant, more patients are competing for limited resources.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Ferreira et al showed that transplantation with the use of expanded criteria deceased donors' kidneys provide quite satisfactory patient and graft survival rates despite their poorer long-term outcomes. 16 As there are now more patients on the waiting list to receive a kidney-after-nonrenal organ transplant, more patients are competing for limited resources. Given the high risk of death in patients with prior nonrenal solid-organ transplantation, perhaps we should appropriately risk stratify these patients as well as consider and encourage the use of expanded criteria donors.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcome of kidney transplant in primary, repeat, and kidney‐after‐nonrenal solid‐organ transplantation: 15‐year analysis of recent UNOS database

El-Husseini

Aghil

Ramírez

et al. 2017

Clinical Transplantation

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The number of nonrenal solid-organ transplants increased substantially in the last few decades. Many of these patients develop renal failure and receive kidney transplantation. The aim of this study was to evaluate patient and kidney allograft survival in primary, repeat, and kidney-after-nonrenal organ transplantation using national data reported to United Network for Organ Sharing (UNOS) from January 2000 through December 2014. Survival time for each patient was stratified into the following: Group A (comparison group)-recipients of primary kidney transplant (178 947 patients), Group B-recipients of repeat kidney transplant (17 819 patients), and Group C-recipients of kidney transplant performed after either a liver, heart, or lung transplant (2365 patients). We compared survivals using log-rank test. Compared to primary or repeat kidney transplant, patient and renal allograft survival was significantly lower in those with previous nonrenal organ transplant. Renal allograft and patient survival after liver, heart, or lung transplants are comparable. Death was the main cause of graft loss in patients who had prior nonrenal organ transplant.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcome of kidney transplant in primary, repeat, and kidney‐after‐nonrenal solid‐organ transplantation: 15‐year analysis of recent UNOS database

El-Husseini

Aghil

Ramírez

et al. 2017

Clinical Transplantation

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“…Furthermore, patients evaluating an older DCD kidney offer are not choosing between an older DCD kidney and a healthier kidney; instead, they are choosing between accepting the current offer or waiting for a better offer that may never come 6,9‐13 . Studies on extended criteria deceased donor transplants have also identified recipient characteristics such as age, race, and time on dialysis as independent risk factors for inferior graft survival 15 and delayed graft function 16 . DCD kidneys from older donors may have the potential to expand the donor pool and provide important survival benefits to transplant candidates 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Survival benefit of accepting kidneys from older donation after cardiac death donors

Long

et al. 2021

American Journal of Transplantation

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Kidneys from older (age ≥50 years) donation after cardiac death (DCD50) donors are less likely to be transplanted due to inferior posttransplant outcomes. However, candidates who decline a DCD50 offer must wait for an uncertain future offer. To characterize the survival benefit of accepting DCD50 kidneys, we used 2010‐2018 Scientific Registry for Transplant Recipients (SRTR) data to identify 92 081 adult kidney transplantation candidates who were offered a DCD50 kidney that was eventually accepted for transplantation. DCD50 kidneys offered to candidates increased from 590 in 2010 to 1441 in 2018. However, 34.6% of DCD50 kidneys were discarded. Candidates who accepted DCD50 offers had 49% decreased mortality risk (adjusted hazard ratio [aHR] 0.460.510.55, cumulative mortality at 6‐year 23.3% vs 34.0%, P < .001) compared with those who declined the same offer (decliners). Six years after their initial DCD50 offer decline, 43.0% of decliners received a deceased donor kidney transplant (DDKT), 6.3% received living donor kidney transplant (LDKT), 22.6% died, 22.0% were removed for other reasons, and 6.0% were still on the waitlist. Comparable survival benefit was observed even with DCD donors age ≥60 (aHR: 0.420.520.65, P < .001). Accepting DCD50 kidneys was associated with a substantial survival benefit; providers and patients should consider these benefits when evaluating offers.

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“…The association of aging with chronic and functional kidney changes has long been acknowledged (1). Kidney recipients from expanded criteria donors (ECDs) are supposed to have inferior midterm renal function and graft survival outcomes (2,3). In addition to decreasing numbers of functional nephrons, deteriorating alloimmune mechanisms contribute to worse graft outcomes in marginal donors.…”

Section: Introductionmentioning

confidence: 99%

Molecular Fingerprints of Borderline Changes in Kidney Allografts Are Influenced by Donor Category

et al. 2020

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Long-Term Outcomes of Kidney Transplantation From Expanded-Criteria Deceased Donors: A Single-Center Experience

Cited by 12 publications

References 21 publications

Outcome of kidney transplant in primary, repeat, and kidney‐after‐nonrenal solid‐organ transplantation: 15‐year analysis of recent UNOS database

Outcome of kidney transplant in primary, repeat, and kidney‐after‐nonrenal solid‐organ transplantation: 15‐year analysis of recent UNOS database

Survival benefit of accepting kidneys from older donation after cardiac death donors

Molecular Fingerprints of Borderline Changes in Kidney Allografts Are Influenced by Donor Category

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