Experiences with expanded criteria donors: 10-year analysis of the Martin, Slovakia Transplant Center
Ivana Dedinska1, Blažej Palkoci1, Juraj Miklušica1, Martin Vojtko1, Jana Malíková1, Ľudovít Laca1.
1Surgery department and transplant center, University Hospital Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia (Slovak Republic)
Background and Aims: Kidneys from expanded criteria donors with diagnosis of brain death have become a part of the organ transplant program, which have thus increased the number of transplants.
Method: In this retrospective analysis, we identified the expanded criteria donors in a group of 156 kidney donors at our center. Basic parameters of the donors before kidney recovery were collected. Graft function, graft survival, and patient survival at 1, 3, and 5 years posttransplant were compared in expanded criteria versus standard criteria donors.
Results: Expanded criteria donors were significantly older than standard criteria donors (P < .001), had higher body mass index (P = .006), and had more frequent arterial hypertension (P < .001) and diabetes mellitus (P = .004) in their histories. When we considered the estimated glomerular filtration rate, graft function in the first 6 months after transplant was significantly worse in kidneys from expanded criteria donors (P = .011). In addition, recipients of grafts from expanded criteria donors had significantly worse survival in the first year posttransplant (P = .023); however, no differences in graft survival were observed.
Conclusion: From the long-term aspect, graft function and graft and patient survival in cases of kidneys from expanded criteria donors were comparable to results with kidneys from standard criteria donors. Expanded use of organs available for transplant is important due to the constantly increasing demands versus limited offers of organs.
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