[Long-term outcomes with expanded criteria donors in kidney transplantation]

Rev Med Chil. 2016 Jan;144(1):22-9. doi: 10.4067/S0034-98872016000100004.
[Article in Spanish]

Abstract

Background: Kidney transplantation of expanded criteria deceased donors (DCE) has become a common clinical practice. However, DCE outcomes are inferior compared to kidney transplants from standard criteria donors (DCS).

Aim: To evaluate intermediate and long-term outcomes of DCE transplanted patients.

Material and methods: Cadaveric kidney transplants were evaluated using a retrospective cohort of eight consecutive years. Complications and long-term function of the transplant were assessed in DCE and DCS kidney recipients.

Results: Of 213 patients analyzed, 34 (16%) underwent DCE transplantation. DCS recipients spent more time on the waiting list for transplantation (p = 0.04). DCE recipients showed higher frequency of surgical complications (p = 0.04), vascular complications (p = 0.02), acute transplant rejection (p = 0.05), and hospitalizations (p = 0.01). Creatinine (mg/dL) in DCE and DCS recipients was 2.3 and 1.5 respectively at year one (p < 0.01) and 2.6 and 1.6 respectively at year five (p < 0.01). Graft survival in the DCE group was significantly lower at 5 years (61 and 89% respectively, p < 0.01).

Conclusions: DCE grafts are associated with lower survival, higher hospitalization rate and commonly develop surgical complications and rejections.

MeSH terms

  • Adolescent
  • Cadaver
  • Chile
  • Graft Rejection
  • Graft Survival
  • Humans
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / mortality
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome