Vaneusa Maria Gomes , Luara Isabela dos Santos , Bernardo Duarte Pessoa de Carvalho Silva , Raquel A. Fabreti-Oliveira
{"title":"Impact of donor expanded criteria kidney transplantation on clinical outcomes and survival: A single-center experience","authors":"Vaneusa Maria Gomes , Luara Isabela dos Santos , Bernardo Duarte Pessoa de Carvalho Silva , Raquel A. Fabreti-Oliveira","doi":"10.1016/j.trim.2024.102116","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>The scarcity of suitable donor organs has led to the inclusion of Expanded Criteria Donor (ECD) kidneys to augment the donor pool, despite potential concerns regarding post-transplant outcomes.</p></div><div><h3>Methods</h3><p>This retrospective study analyzed the clinical outcomes of a cohort of 317 kidney transplant recipients from deceased donors at a single center between 2008 and 2018. Patients were categorized into ECD and Standard Criteria Donor (SCD) groups, with primary nonfunctioning grafts excluded. Comprehensive laboratory evaluations were conducted, including HLA typing and serum creatinine levels. Immunosuppressive regimens were standardized, and statistical analyses were performed using the SPSS program.</p></div><div><h3>Results</h3><p>The sample consisted of 83 (26.18%) patients who received kidney transplants from ECDs and 234 (73.82%) from SCDs. The ECD group showed a longer cold ischemia time (<em>p</em> = 0.019) and a higher rate of delayed graft function (DGF) compared with the SCD group. No significant differences were observed in graft survival (<em>p</em> = 0.370) or patient survival (<em>p</em> = 0.993) between the ECD and SCD groups. However, differences in graft survival were noted between the groups when stratified by DGF status: ECD with DGF vs. ECD without DGF (<em>p</em> = 0.029), ECD with DGF vs. SCD with DGF (<em>p</em> = 0.188), ECD with DGF vs. SCD without DGF (<em>p</em> = 0.022), ECD without DGF vs. SCD with DGF (<em>p</em> = 0.014), ECD without DGF vs. SCD without DGF (<em>p</em> = 0.340), and SCD with DGF vs. SCD without DGF (<em>p</em> = 0.195). No differences in patient survival rates were observed among these groups for all pairwise comparisons (<em>p</em> > 0.05) when stratified by donor criteria and DGF status.</p></div><div><h3>Conclusions</h3><p>Graft and patient survival rates were comparable between ECD and SCD kidney transplant recipients.</p></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"86 ","pages":"Article 102116"},"PeriodicalIF":1.6000,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplant immunology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0966327424001321","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
The scarcity of suitable donor organs has led to the inclusion of Expanded Criteria Donor (ECD) kidneys to augment the donor pool, despite potential concerns regarding post-transplant outcomes.
Methods
This retrospective study analyzed the clinical outcomes of a cohort of 317 kidney transplant recipients from deceased donors at a single center between 2008 and 2018. Patients were categorized into ECD and Standard Criteria Donor (SCD) groups, with primary nonfunctioning grafts excluded. Comprehensive laboratory evaluations were conducted, including HLA typing and serum creatinine levels. Immunosuppressive regimens were standardized, and statistical analyses were performed using the SPSS program.
Results
The sample consisted of 83 (26.18%) patients who received kidney transplants from ECDs and 234 (73.82%) from SCDs. The ECD group showed a longer cold ischemia time (p = 0.019) and a higher rate of delayed graft function (DGF) compared with the SCD group. No significant differences were observed in graft survival (p = 0.370) or patient survival (p = 0.993) between the ECD and SCD groups. However, differences in graft survival were noted between the groups when stratified by DGF status: ECD with DGF vs. ECD without DGF (p = 0.029), ECD with DGF vs. SCD with DGF (p = 0.188), ECD with DGF vs. SCD without DGF (p = 0.022), ECD without DGF vs. SCD with DGF (p = 0.014), ECD without DGF vs. SCD without DGF (p = 0.340), and SCD with DGF vs. SCD without DGF (p = 0.195). No differences in patient survival rates were observed among these groups for all pairwise comparisons (p > 0.05) when stratified by donor criteria and DGF status.
Conclusions
Graft and patient survival rates were comparable between ECD and SCD kidney transplant recipients.
期刊介绍:
Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.