Analysis of local versus imported expanded criteria donor kidneys: A single-center experience with 497 ECD kidney transplants.

Abstract:

BACKGROUND:The value of importing expanded criteria donor (ECD) kidneys is uncertain. METHODS:We retrospectively reviewed our single-center experience with ECD kidney transplants (KT). RESULTS:Over 12.8 years, we performed 497 ECD KTs including 247 local and 250 imported from other donor service areas. The import ECD group had more donors (16% vs 9%) ≥ age 70, more zero human leukocyte antigen mismatches (14% vs 2%), more KTs with a cold ischemia time >30 hours (46% vs 19%), and fewer kidneys managed with pump preservation (78% vs 92%, all P≤.05) compared to the local ECD group. Mean Kidney Donor Profile Index were 80% import vs 84% local. With a mean follow-up of 55 months, actual patient and graft survival rates were 71% and 58% in import vs 76% and 58% in local ECD KTs, respectively. Death-censored graft survival rates were 70% in import vs 69% in local ECD KTs. Delayed graft function occurred in 28% import vs 23% local ECD KTs (P=NS) whereas the incidence of primary nonfunction was slightly higher with import ECD kidneys (4.8% vs 2.4%, P=.23). CONCLUSIONS:Midterm outcomes are remarkably similar for import vs local ECD KTs, suggesting that broader sharing of ECD kidneys may improve utilization without compromising outcomes.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Khan MA,El-Hennawy H,Farney AC,Rogers J,Orlando G,Reeves-Daniel A,Palanisamy A,Gautreaux M,Iskandar S,Doares W,Kaczmorski S,Stratta RJ

doi

10.1111/ctr.13029

subject

Has Abstract

pub_date

2017-08-01 00:00:00

issue

8

eissn

0902-0063

issn

1399-0012

journal_volume

31

pub_type

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