Five-year experience with the new Eurotransplant kidney allocation system, 1996 to 2001

Persijn, G. G.; Smits, Jacqueline M.; Smith, M; Frei, Ulrich

doi:10.1016/s0041-1345(02)03579-0

Cited by 12 publications

(6 citation statements)

References 4 publications

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“…avoids long waiting times for those with uncommon HLA profiles by incorporating an index of ''matchability.'' This approach is used successfully by Eurotransplant (17,(24)(25)(26)(27). The Eurotransplant algorithm balances a preference for well-matched kidneys against the likelihood of obtaining a good match, thereby maintaining HLA matching as part of the algorithm without unfairly disadvantaging patients for whom it is difficult to find a good match.…”

Section: Discussionmentioning

confidence: 99%

Impact of HLA Mismatch at First Kidney Transplant on Lifetime With Graft Function in Young Recipients

Foster

Dahhou

Zhang

et al. 2014

American Journal of Transplantation

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As HLA matching has been progressively de-emphasized in the American deceased donor (DD) kidney allocation algorithm, concerns have been raised that poor matching at first transplant may lead to greater sensitization and more difficulty finding an acceptable donor for a second transplant should the first transplant fail. We compared proportion of total observed lifetime with graft function after first transplant, and waiting times for a second transplant between individuals with different levels of HLA mismatch (MM) at first transplant. We studied patients recorded in the United States Renal Data System (1988System ( -2009) who received a first DD transplant at age 21 years (n ¼ 8433), and the subgroup who were listed for a second DD transplant following first graft failure (n ¼ 2498). Compared with recipients of 2-3 MM first grafts, 4-6 MM graft recipients spent 12% less of their time and 0-1 MM recipients 15% more time with a functioning graft after the first transplant (both p < 0.0001); 4-6 MM recipients were significantly less likely (hazard ratio [HR]

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Section: Discussionmentioning

confidence: 99%

Impact of HLA Mismatch at First Kidney Transplant on Lifetime With Graft Function in Young Recipients

Foster

Dahhou

Zhang

et al. 2014

American Journal of Transplantation

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“…52 Points waiting, highly-sensitised, rare HLA-phenotype and paediatric patients, and equalising the international imbalances in organ exchange. 54,55 Eurotransplant was the first organisation to develop special allocation programs for specific groups of patients ( Figure 2). The Acceptable Mismatch Program (AMP) was introduced in 1996 for highly-sensitised patients (PRA >85%), where it is determined which HLA-antigens the patient does not have antibodies against, and priority is given for any donor with acceptable antigens.…”

Section: New Zealandmentioning

confidence: 99%

Global trends and challenges in deceased donor kidney allocation

Watson

Bradley

et al. 2017

Kidney International

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Worldwide, the number of patients able to benefit from kidney transplantation is greatly restricted by the severe shortage of deceased donor organs. Allocation of this scarce resource is increasingly challenging and complex. Striking an acceptable balance between efficient use of (utility) and fair access to (equity) the limited supply of donated kidneys raises controversial but important debates at ethical, medical, and social levels. There is no international consensus on the recipient and donor factors that should be considered in the kidney allocation process. There is a general trend toward a reduction in the influence of human leukocyte antigen mismatch and an increase in the importance of other factors shown to affect posttransplant outcomes, such as cold ischemia, duration of dialysis, donor and recipient age, and comorbidity. Increased consideration of equity has led to improved access to transplantation for disadvantaged patient groups. There has been an overall improvement in the transparency and accountability of allocation policies. Novel and contentious approaches in kidney allocation include the use of survival prediction scores as a criterion for accessing the waiting list and at the point of organ offering with matching of predicted graft and recipient survival. This review compares the diverse international approaches to deceased donor kidney allocation and their evolution over the last decade.

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“…Die chi rur gi schen Teams der Ent nahme wer den durch Mit ar bei ter der deutschen Trans plan ta ti ons zen tren ge bil det, die über eine ent spre chen de Ex per ti se verfü gen. Die Vor raus set zun gen (Hirn tod diagno s tik, Kri te ri en für Or gan spen der) sowie der or ga ni sa to ri sche Ab lauf ei ner Entnah me und die Or ga nal lo ka ti on sind klar ge re gelt [7,11,12].…”

Section: Pan Kre As or Gan Ent Nah Meunclassified

Pankreasorganentnahme durch externe Teams

Schulz

Flecken

Schenker

et al. 2005

Chirurg

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Combined pancreas and kidney transplantation is an established procedure for terminal or preterminal, uremic, type 1 diabetics. The current procurement technique allows simultaneous recovery of liver and pancreas. One problem is the assessment of organ quality. It remains unclear how many pancreas organs must be withdrawn during back-table preparation. Between June 1994 and December 2003, 271 pancreas transplantations were performed at our transplant centre. Two hundred sixty-two (89.7%) pancreas grafts were harvested by teams which were not part of the transplant team. Twenty-one (8.0%) grafts were discharged for transplantation at the time of back-table preparation. Liposis of the graft and critical vessel situations were the main reasons for withdrawal. Two kidney grafts were not usable for transplantation, and 92% of the pancreas grafts were. This demonstrates the high standard of pancreas procurement in the Eurotransplant region.

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Five-year experience with the new Eurotransplant kidney allocation system, 1996 to 2001

Cited by 12 publications

References 4 publications

Impact of HLA Mismatch at First Kidney Transplant on Lifetime With Graft Function in Young Recipients

Impact of HLA Mismatch at First Kidney Transplant on Lifetime With Graft Function in Young Recipients

Global trends and challenges in deceased donor kidney allocation

Pankreasorganentnahme durch externe Teams

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