Impact of donor expanded criteria kidney transplantation on clinical outcomes and survival: A single-center experience

IF 1.6 4区医学 Q4 IMMUNOLOGY

Transplant immunology Pub Date : 2024-09-02 DOI:10.1016/j.trim.2024.102116

Vaneusa Maria Gomes , Luara Isabela dos Santos , Bernardo Duarte Pessoa de Carvalho Silva , Raquel A. Fabreti-Oliveira

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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.

查看原文本刊更多论文

供体扩大标准肾移植对临床结果和存活率的影响：单中心经验。

导言：尽管存在对移植后结果的潜在担忧，但合适的供体器官的稀缺已导致纳入扩大标准供体（ECD）肾脏以扩大供体库：这项回顾性研究分析了一个中心在 2008 年至 2018 年间 317 名肾移植受者的临床结果。患者被分为ECD组和标准标准捐献者（SCD）组，排除了原发性无功能移植物。进行了全面的实验室评估，包括 HLA 分型和血清肌酐水平。对免疫抑制方案进行了标准化，并使用 SPSS 程序进行了统计分析：样本包括 83 名（26.18%）接受 ECD 肾移植的患者和 234 名（73.82%）接受 SCD 肾移植的患者。与 SCD 组相比，ECD 组的冷缺血时间更长（p = 0.019），移植物功能延迟率（DGF）更高。在移植物存活率（p = 0.370）或患者存活率（p = 0.993）方面，ECD 组和 SCD 组之间未观察到明显差异。但是，根据 DGF 状态进行分层后，发现两组之间的移植物存活率存在差异：有 DGF 的 ECD 组与没有 DGF 的 ECD 组（p = 0.029）、有 DGF 的 ECD 组与有 DGF 的 SCD 组（p = 0.188）、有 DGF 的 ECD 组与没有 DGF 的 SCD 组（p = 0.022）、没有 DGF 的 ECD 组与有 DGF 的 SCD 组（p = 0.014）、没有 DGF 的 ECD 组与没有 DGF 的 SCD 组（p = 0.340）以及有 DGF 的 SCD 组与没有 DGF 的 SCD 组（p = 0.195）。根据供体标准和DGF状态进行分层后，在所有成对比较中均未观察到各组间患者存活率的差异（p > 0.05）：结论：ECD和SCD肾移植受者的移植物和患者存活率相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant immunology 医学-免疫学

CiteScore

2.10

自引率

13.30%

发文量

198

审稿时长

48 days

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.