Outcome of Kidney Transplantation From High-Risk Donors Is Determined by Both Structure and Function

Karpinski, Jolanta; Lajoie, Ginette; Cattran, Daniel C.; Fenton, Stanley; Zaltzman, Jeffrey S.; Cardella, Carl J.; Cole, Edward

doi:10.1097/00007890-199904270-00013

Cited by 210 publications

(155 citation statements)

References 24 publications

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“…Nevertheless, numerous studies have shown that graft function and survival are affected by different donor nonimmunological factors, such as donor age, gender, race, size, and mode of death (1)(2)(3)(4). Fewer studies have analyzed the influence of donor kidney function on subsequent graft function but this influence has been reported as significant (5), modest (6,7) or even nonsignificant (3). In these studies kidney or graft function was most commonly estimated by creatinine clearance, as calculated by the Cockcroft-Gault formula, and the influence of donor factors was examined on graft function at multiple timepoints (3,7,8).…”

Section: Introductionmentioning

confidence: 99%

Donor Kidney Glomerular Filtration Rate and Post-Transplant Graft Function

Ležaić¹,

Naumovic²,

Marinković³

et al. 2004

American Journal of Transplantation

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This study aimed to estimate the relationship between the single kidney glomerular filtration rate (SKGFR) of a planned kidney transplant and the subsequent graft function and survival of living related kidney recipients (LKRs). Of 180 LKRs with the graft functioning for more than a year, 70 patients without delayed graft function (DGF) or acute rejection (AR) were selected for the study. According to SKGFR, assessed by 99m TcDTPA, the patients were allocated into Group 1, receiving kidney with SKGFR < 50 mL/min (32 patients), and Group 2, with SKGFR > 50 mL/min (38 patients). The database included donor, recipient and transplant variables. No significant difference was found between the patient and graft survival rate, creatinine clearance (CCr) and the rate of CCr change between the groups. Additional evaluation revealed no significant influence of the ratio of SKGFR and the recipient's body weight/size on patient and graft outcome. The analysis of factors of influence on patient and graft survival and function revealed the major influence of nonimmunological factors but not of SKGFR of the transplanted kidney. Our study did not confirm the influence of SKGFR on graft function and survival in the LKRs without DGF and AR but the limited number of patients must not be disregarded.

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Section: Introductionmentioning

confidence: 99%

Donor Kidney Glomerular Filtration Rate and Post-Transplant Graft Function

Ležaić¹,

Naumovic²,

Marinković³

et al. 2004

American Journal of Transplantation

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“…Karpinski és mtsai 34 donor vesebiopsziás mintáit vizsgálták az alábbi szempontok alapján: glomerulosclerosis, interstitialis fibrosis, tubularis atrophia és vascularis eltéré-sek [25]. Ezen a vizsgálaton alapszik a Remuzzi (Pirani) -score is, amely a szövettani eltéréseket pontozva három fő csoportba sorolja a veséket aszerint, hogy mennyi életképes nefron található bennük [26].…”

Section: Eredeti Közleményunclassified

Donorszelekciós kritériumok vizsgálata a debreceni veseátültetési programban

et al. 2016

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Bevezetés: A donorszervhiány, a donorok életkorának növekedése és a társbetegségek gyakoribbá válása arra ösztönzi a transzplantálóközpontokat, hogy olyan donorvesék elfogadását is mérlegeljék, amelyeket korábban elutasítottak volna. A donorszelekciós kritériumok segíthetnek ennek eldöntésében. Célkitűzés: A különböző kritériumok hasznosságát illetően nincs egységes álláspont, ezért a szerzők megvizsgálták az expanded criteria donor, a deceased donor score és a kidney donor risk index donorszelekciós kritériumok hatását a posztoperatív vesefunkcióra és grafttúlélésre. Módszer: Ötéves intervallumban 205 donor paramétereinek és 138 veseátültetés kimenetelének retrospektív elemzé-sét végezték el. Eredmények: Az expanded criteria donor rendszer szerint optimálisnak véleményezett donorok negyede a magas kockázatú csoportba került a deceased donor score alapján. A magas kockázatú csoportokban rosszabb volt a műtét utáni graftfunkció. A deceased donor score segítségével tovább lehetett bontani a magas kockázatú csoportot. Az így létrejött legmagasabb kockázatú csoport grafttúlélése és műtét utáni graftműködése elmaradt a többi csoportéhoz képest. Következtetések: A vizsgált pontrendszerek segíthetnek a donorpool biztonságos növelé-sében. Orv. Hetil., 2016, 157(24), 946-955. Kulcsszavak: veseátültetés, kiterjesztett donorkritériumok, kimenetel, marginális donor Analysis of donor scoring systems in a single Hungarian transplant centreIntroduction: To ease organ shortage many transplant centres developed different donor scoring systems, however, a general consensus among clinicians on the use of these systems does not still exist. Aim: The aim of the authors was to analyse the effect of expanded criteria donor, deceased donor score and kidney donor risk index on postoperative kidney function and graft survival. Method: Analysis of the characteristics of 138 kidney transplantations and 205 donors in a retrospective study of a five-year period. Results: There was a trend towards rejecting donors in higher risk groups; 22.7% of standard criteria donors belonged to the high risk group of deceased donor score. Graft function was worse in high risk patients. High risk donors can be divided due to the use of deceased donor score. Patients with the highest risk had worse graft function and survival. Conclusions: With the use of these scoring systems grafts with favourable outcome can be selected more precisely.

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“…Outcomes of ECD kidney transplantation are improved when a pre-implantation biopsy of the donor kidney is evaluated using the scoring system introduced by Karpinski and colleagues (Karpinski et al, 1999) . Using this system, donor renal pathology is scored from 0 to 3 (none to severe disease) in 4 areas: glomerulosclerosis, interstitial fibrosis, tubular atrophy, and vascular disease.…”

Section: Role Of Kidney Biopsymentioning

confidence: 99%