Reasons for non-use of recovered kidneys: the effect of donor glomerulosclerosis and creatinine clearance on graft survival.

Abstract:

BACKGROUND:In 2000, the United Network for Organ Sharing/Organ Procurement and Transplantation Network Registry reported 540 recovered kidneys were discarded because of biopsy results, and 210 were discarded because of poor organ function. We compared the percentage of glomerulosclerosis (GS) and creatinine clearance (CrCl) of both discarded and transplanted cadaveric kidneys and examined their effect on graft survival and function. METHODS:The cohort consisted of all cadaveric kidneys (n= 3,444) with reported biopsy results between October 25, 1999 and December 31, 2001. Graft survival was calculated by univariate and multivariate models. RESULTS:Fifty-one percent of discarded kidneys had GS of less than 20%, 27% had a CrCl greater than 80 mL/min, and 15% (129 kidneys) had both GS less than 20% and a CrCl of greater than 80 mL/min. Univariate analyses of kidneys with less than or equal to 20% GS revealed no difference in 1-year graft survival when the CrCl was greater than or less than or equal to 80 mL/min. When GS was greater than 20%, 1-year graft survival of kidneys with a CrCl of greater than 80 mL/min was significantly greater than that of kidneys with a CrCl of less than or equal to 80 mL/min. Multivariate results showed no significant difference in relative risk of graft loss with GS greater than 20% versus less than or equal to 20% when the CrCl was either 50 or 80 mL/min. With both GS less than or equal to 20% and greater than 20%, serum creatinine at 1 year was significantly lower in kidneys with CrCl greater 80 mL/min. CONCLUSIONS:Calculated donor CrCl does, and percentage GS on donor kidney biopsies does not, correlate well with 1-year graft survival and function, and percentage GS should not be used as the sole criterion for discarding recovered cadaveric kidneys.

journal_name

Transplantation

journal_title

Transplantation

authors

Edwards EB,Posner MP,Maluf DG,Kauffman HM

doi

10.1097/01.tp.0000123080.19145.59

subject

Has Abstract

pub_date

2004-05-15 00:00:00

pages

1411-5

issue

9

eissn

0041-1337

issn

1534-6080

pii

00007890-200405150-00018

journal_volume

77

pub_type

杂志文章
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    更新日期:1998-01-27 00:00:00

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    pub_type: 杂志文章

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    authors: Alexander JA,Demetrius AJ,Gavaler JS,Makowka L,Starzl TE,Van Thiel DH

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    doi:10.1097/00007890-198708000-00022

    authors: Servilla KS,Burnham DK,Daynes RA

    更新日期:1987-08-01 00:00:00