Title
Shipping donor kidneys within Eurotransplant : outcomes after renal transplantation in a single-centre cohort study Shipping donor kidneys within Eurotransplant : outcomes after renal transplantation in a single-centre cohort study
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Berlin ,
Subject
Human medicine
Source (journal)
Nephrology, dialysis, transplantation. - Berlin
Volume/pages
27(2012) :9 , p. 3638-3644
ISSN
0931-0509
ISI
000308244400041
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Abstract
Shipment of organs during the allocation process aims to improve human leucocyte antigen (HLA) matching but can also have a detrimental effect by prolonging cold ischaemia. The overall effect of organ exchange on post-transplant outcomes in the Eurotransplant (ET) region has not been investigated. This is a retrospective single-centre cohort study to investigate the effect of shipment of renal allografts on cold ischaemia times and the incidence of acute rejection (AR) and graft survival in 661 transplantations of deceased donor kidneys. Forty-six per cent (N 301) of the patients received a locally procured and 54 (N 360) a shipped donor kidney. Locally procured donors tended to be older, more often hypertensive and had less frequently died from trauma. Recipients of shipped kidneys were at higher immunological risk, being younger, more frequently retransplanted and immunized against HLA antigens. Shipped kidneys had a 2.2-h prolongation of cold ischaemia time (18.0 versus 20.2 h; P 0.0001) but significantly less HLA A, B and DR mismatches (2.20 versus 2.84; P 0.0001). Recipients of shipped kidneys had an increased incidence of first-year AR [19 versus 13; odds ratio 1.62 (1.062.49); P 0.026] and death-censored graft loss [hazard ratio 1.6 (1.12.4); P 0.01] that was no longer statistically significant after adjustments for risk factors by multivariable modelling. Shipment of kidneys in the ET region is associated with a modest increase in cold ischaemia time and significantly better HLA matching. This allows for successful transplantation of higher risk patients with no significant penalty with regard to AR rates or death-censored graft survival.
Full text (open access)
https://repository.uantwerpen.be/docman/irua/ea946d/9008.pdf
E-info
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000308244400041&DestLinkType=RelatedRecords&DestApp=ALL_WOS&UsrCustomerID=ef845e08c439e550330acc77c7d2d848
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000308244400041&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=ef845e08c439e550330acc77c7d2d848
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000308244400041&DestLinkType=CitingArticles&DestApp=ALL_WOS&UsrCustomerID=ef845e08c439e550330acc77c7d2d848