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Outcome of Kidney Transplantation from Expanded Criteria Deceased Donors

Raslan, Mohamed; Samhan, Mahmoud; Halabi, Eyad; Shanab, Jellan; Matheow, Bobby; Al Shomali, Wael; Al Mousawi, Moustafa

doi: 10.1097/01.tp.0000520369.76323.8b
211.7
Free

Organ Transplant Center, Ministry of Health, Kuwait City, Kuwait.

Our Center Study.

Introduction: The use of kidneys from expanded criteria deceased donors (ECD) has been generally accepted in view of the global shortage of organs available for transplantation and the increasing disparity between organ supply and demand.

Aim: To explore the outcome of kidney transplantation from ECD in comparison to that from standard criteria deceased donor (SCD).

Patients and Methods: The medical records of patients who received kidney transplants between January 2011 and December 2014 were retrospectively reviewed. 103 patients received kidney transplantation from deceased donors at Hamed Al-Essa Centre during this period. 22 (21%) grafts were obtained from ECD and 81 (79%) grafts from SCD. Recipients of ECD grafts were 12 males and 10 females aged 19 years to 65 years at the time of transplantation, and the procedure was re-transplantation (2nd or 3rd transplant) in 9% of recipients. Recipients of SCD grafts were 46 males and 35 females, aged 5 years to 77 years at the time of transplantation, and the procedure was re-transplantation in 15% of recipients.

Results: Kidney transplantation from ECD was associated with 9 (41%) instances of surgical complications, and showed 50% primary graft function, 27 % delayed graft function, and 23% primary graft non-function. The mean hospital stay was 16 days. There was no recipient death but 5 grafts were lost at 1–10 days post transplantation. The 1-year and 4-year survival rates were 100% and 100% respectively for recipients and 77% and 77% respectively for grafts. Kidney transplantation from SCD was associated with 29 (36%) instances of surgical complications, and showed 52% primary graft function, 42 % delayed graft function, and 6% primary graft non-function. The mean hospital stay was 22 days. Four recipients died with functioning grafts at 2 to 6 months after transplantation, and 13 grafts were lost at 1- day to 3 years post transplantation. The 1-year and 4-year survival rates were 81% and 77% respectively for recipients and 81% and 64% respectively for grafts.

Conclusion: 1- ECD represent a good source of kidneys for transplantation. (2) Kidney transplantation from ECD is associated with similar rates of recipient and graft survival compared to those obtained in kidney transplantation from SCD.

Keywords: Kidney Transplantation, Expanded Criteria Donor, Deceased Donors

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