Donor characteristics associated with reduced graft survival: an approach to expanding the pool of kidney donors1

Port, Friedrich K.; Bragg‐Gresham, Jennifer L.; Metzger, Robert A.; Dykstra, Dawn M.; Gillespie, Brenda W.; Young, Eric W.; Delmonico, Francis L.; Wynn, James J.; Merion, Robert M.; Wolfe, Robert A.; Held, Philip J.

doi:10.1097/00007890-200211150-00014

Cited by 719 publications

(589 citation statements)

References 7 publications

Supporting

Mentioning

558

Contrasting

Unclassified

Order By: Relevance

“…The ECD kidney values represent the relative risk of graft loss compared to an ideal donor kidney (17). The mean and median ECD relative risk of the kidneys in our group was modest at 1.24 -0.29 and 1.14 ( Table 6); only nine kidneys (6.8%) met the definition of an ECD kidney.…”

Section: Baseline Characteristicsmentioning

confidence: 81%

“…Each index combines different donor, recipient, and/or transplant factors with varying weights to stratify the 'quality' of either the kidney or the transplant. The Expanded Criteria Donor (ECD) index uses four donor criteria to determine the relative risk of graft failure (17) and forms the basis for a new allocation strategy designed to expedite placement of suboptimal kidneys. Two of the indices, Sangstat (18) and Novartis (19), were derived to identify transplant recipients at high risk of DGF.…”

Section: Immunosuppression and Rejectionmentioning

confidence: 99%

See 1 more Smart Citation

Sirolimus Prolongs Recovery from Delayed Graft Function After Cadaveric Renal Transplantation

McTaggart

Gottlieb

Brooks

et al. 2003

American Journal of Transplantation

163

View full text Add to dashboard Cite

Sirolimus, lacking known nephrotoxicity, appeared to be an ideal immunosuppressive agent in the setting of delayed graft function (DGF) after renal transplantation. Coincident with our use of sirolimus however, we noticed prolongation of DGF. To investigate possible causes of prolonged DGF, extensive donor, recipient, transplant, and post-transplant data were collected on 132 consecutive cases of DGF at the University of California, San Francisco between 1/1/97 and 6/30/01. Cox proportional hazards analysis of time to graft function was used in univariate and multivariate models to identify factors that prolong DGF. Sirolimus had a large and highly significant effect on time to graft function (hazard ratio 0.48, p = 0.0007). The hazard ratio indicates that a recipient on sirolimus is half as likely to resolve DGF or twice as likely to remain on dialysis as a recipient without sirolimus. Two other factors had less potent but still significant association with DGF duration: recipient sensitization (hazard ratio 0.66, p = 0.037), and Novartis score (hazard ratio 0.93 per 1.0 increase; p = 0.034). Sirolimus retained its profound negative association with time to graft function in all multivariate models. Because sirolimus appears to prolong DGF, it may not be the optimal immunosuppressive choice in the DGF setting.

show abstract

Section: Baseline Characteristicsmentioning

confidence: 81%

Section: Immunosuppression and Rejectionmentioning

confidence: 99%

Sirolimus Prolongs Recovery from Delayed Graft Function After Cadaveric Renal Transplantation

McTaggart

Gottlieb

Brooks

et al. 2003

American Journal of Transplantation

163

View full text Add to dashboard Cite

show abstract

“…The percentage of discarded kidneys has remained stable in the last 3 years -it varies around 22% (Table 3). There are an important number of donors (between 140 and 160) from whom both kidneys are discarded, but the liver is effectively grafted (11). In less than 5% of all discarded kidneys, the reason for discarding is related to technical problems that could have been avoided.…”

Section: Organ Donation and Transplantation Evolution In Spain (10)mentioning

confidence: 99%

Optimizing Cadaveric Organ Procurement: the Catalan and Spanish Experience

Miranda

Vilardell²,

Grinyó

2003

American Journal of Transplantation

View full text Add to dashboard Cite

The need to face the increasing gap between the supply and the demand of transplants has led to the development of a permanent network of trained medical staff responsible for the organ donation and removal process in all centers accredited for that process. In Spain, this activity received a specific budget, like any other medical activity in hospitals, and the responsible staff became accountable for performance. This system dramatically increased the number of potential donors referred, not only young donors with trauma, but also elderly donors dying from stroke. The effect was that the donation rate increased by more than 100% in 10 years (from 14 to 34 donors per million population). Consequently, so did all the transplant figures. In some areas, such as Catalonia, it has been demonstrated that sustained kidney transplant activity of over 60 procedures per million population can maintain or slightly decrease the waiting list, despite increasing incidence and prevalence of end-stage renal failure. Quality monitoring of the donation and retrieval process shows that there are still opportunities for improvement if all potential donors are referred and all technical problems are overcome. Living donation and nonheart beating organ retrieval should also be promoted.

show abstract

“…Organs from so-called expanded criteria donors (ECD) have been used to meet this rapidly increasing demand and currently more than half of kidney allografts come from donors over 50 years old (1). ECD allografts are associated with poorer posttransplant function and lower rates of allograft survival (2) and are allocated in most allocation programs to old recipients (3).…”

Section: Introductionmentioning

confidence: 99%

Th-17 Alloimmune Responses in Renal Allograft Biopsies From Recipients of Kidney Transplants Using Extended Criteria Donors During Acute T Cell–Mediated Rejection

Matignon

Aissat

Canouï‐Poitrine

et al. 2015

American Journal of Transplantation

View full text Add to dashboard Cite

Donor characteristics associated with reduced graft survival: an approach to expanding the pool of kidney donors1

Abstract: By identifying donor factors associated with graft failure, these analyses may help to expand the number of transplanted kidneys by increasing the utilization of retrieved cadaveric kidneys.

Cited by 719 publications

References 7 publications

Sirolimus Prolongs Recovery from Delayed Graft Function After Cadaveric Renal Transplantation

Sirolimus Prolongs Recovery from Delayed Graft Function After Cadaveric Renal Transplantation

Optimizing Cadaveric Organ Procurement: the Catalan and Spanish Experience

Th-17 Alloimmune Responses in Renal Allograft Biopsies From Recipients of Kidney Transplants Using Extended Criteria Donors During Acute T Cell–Mediated Rejection

Contact Info

Product

Resources

About