Publication
Title
Shipping donor kidneys within Eurotransplant : outcomes after renal transplantation in a single-centre cohort study
Author
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.
Language
English
Source (journal)
Nephrology, dialysis, transplantation. - Berlin
Publication
Berlin : 2012
ISSN
0931-0509
Volume/pages
27:9(2012), p. 3638-3644
ISI
000308244400041
Full text (Publisher's DOI)
Full text (open access)
UAntwerpen
Faculty/Department
Publication type
Subject
External links
Web of Science
Record
Identification
Creation 06.01.2015
Last edited 19.06.2017