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Does multiorgan versus kidney-only cadaveric organ procurement affect graft outcomes?

Abstract：

INTRODUCTION:The majority of kidney grafts in most European countries still come from deceased donors who provide other organs. We analyzed whether multiorgan procurement portends a worse functional outcome compared with kidney-only harvesting. METHODS:We performed a retrospective analysis of 1043 consecutive brain-dead donor kidney transplantations performed at a single academic institution from September 2002 to June 2011. The graft outcomes using kidney-only donors (n = 243) were compared with multiorgan donor grafts (n = 800) analyzing donor age, gender, cause of death, duration of mechanical ventilation, renal function, and cold ischemic interval. We compared delayed graft function and serum creatinine values at 1, 3, 6, and 12 months posttransplantation as well as graft survivals. This methodology was also applied to the subset of expanded criteria donors: 179 kidney-only versus 474 multiorgan. The influence of donor variables on graft survival was also analyzed in a Cox regression model. Immunosuppressive regimens and preservation solutions were similar in both groups. RESULTS:Kidney-only donors were older than their multiorgan counterparts (53.1 versus 44.8, P < .0005) and predominantly male (76.5% versus 62.6% male donors, P < .0005). Other donor variables were comparable. Kidney-only donor grafts showed a slightly higher incidence of delayed function (27.2 versus 21.1%, P = .049), but the mean serum creatinine values were similar at all intervals. No differences were observed in 7-year graft survival: 80.7% versus 79.9%. Expanded criteria donor grafts showed overlapping results, except for a higher rate of donor oligoanuria and a lower 1-month mean creatinine among kidney-only donors. Multivariate analysis revealed that the number of harvested organs did not influence graft survival. DISCUSSION:Immediate and long-term outcomes of kidney grafts did not correlate with the number of organs harvested from the donor. The longer explantation time associated with multiorgan procurement did not seem to affect graft function.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Castelo D,Campos L,Moreira P,Furriel F,Parada B,Nunes P,Figueiredo A,Mota A

doi

10.1016/j.transproceed.2013.02.026

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

1248-50

issue

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(13)00175-9

journal_volume

pub_type

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Does multiorgan versus kidney-only cadaveric organ procurement affect graft outcomes?