The 6‐year clinical outcomes for patients registered in a multiregional United States Kidney Paired Donation program ‐ a retrospective study
| Autor: | Stanislaw M. Stepkowski, Connie Smith, Beata Mierzejewska, Susan Rees, Caitlin E. Baum, Robert J. Brunner, Michael A. Rees, Itai Ashlagi, Jonathan E. Kopke, Sadik A. Khuder, Dulat Bekbolsynov, David Fumo, Alvin E. Roth |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Tissue and Organ Procurement Databases Factual Kidney Paired Donation Internal medicine Living Donors medicine Humans Donor pool Kidney transplantation Retrospective Studies Family Health Transplantation Kidney business.industry Graft Survival Retrospective cohort study Middle Aged medicine.disease Kidney Transplantation United States Organ procurement Treatment Outcome medicine.anatomical_structure Donation cardiovascular system Kidney Failure Chronic Female business Algorithms |
| Zdroj: | Transplant International. |
| ISSN: | 1432-2277 0934-0874 |
| DOI: | 10.1111/tri.13423 |
| Popis: | We examined what happened during a 6-year period to 1121 end-stage renal disease patients who registered with their willing/incompatible living donors for kidney exchanges with the Alliance for Paired Donation (APD). Of all patients, 65% were transplanted: 37% in kidney paired donation (APD-KPD, APD-other-KPD); 10% with compatible live donors (APD-LD); and 18% with deceased donors (APD-DD). The remaining patients were withdrawn (sick/died/others; 15%), or were still waiting (20%). For those patients with a cPRA 0-94%, 72% received a transplant. In contrast, only 49% of very highly sensitized (VHS; cPRA 95-100%) were transplanted. Of the VHS patients, 50% were transplanted by KPD/APD-LD while 50% benefited through prioritization of deceased donors in the modified kidney allocation system (KAS introduced in 2014). All APD transplanted groups had similar death-censored 4-year graft survivals as their relevant Organ Procurement and Transplantation Network (OPTN) groups. It is noteworthy that VHS graft and patient survival results were comparable to less sensitized and nonsensitized patients. All patients should be encouraged to search for compatible donors through different options. Expanding the donor pool through KPD and the new KAS of the OPTN increases the likelihood of transplantation for VHS patients. |
| Databáze: | OpenAIRE |
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