The survival of recipients and renal grafts from expanded criteria deceased donors
Alexej V Pinchuk1,2,3, Nonna V Shmarina1, Yuriy Anisimov1, Ilia V Dmitriev1, Aslan G Balkarov1, Roman V Storogev1, Alexander S Kondrashkin1, Denis V Lonshakov1, Roman S Kalashnik1.
1Kidney and pancreas transplantation department, SRI for Emergency Care n.a.N.V.Sklifosovsky, Moscow, Russian Federation; 2Department of transplantology and artificial organs, Moscow State University of Medicine and Dentistry, Moscow, Russian Federation; 3Methodic and organization department for organ transplantation, Scientific-research Institute of Health Organization and Medical Management, Moscow, Russian Federation
Introduction: The growing demand for transplants has led to an expansion of the criteria for organ donation.
The aim: To compare the 1- and 5-year survival of recipients and kidney grafts’ from donors with standard and extended criteria after primary kidney transplantation (KTx).
Methods: Out of 1,459 recipients after primary KTx performed from 2007 to 2019, a sample (n=196) was stratified by gender, age and type of donor. In recipients of group I renal grafts were harvesting from standard donors (n=134), in group II – from extended criteria donors (ECD, n=62). ECDs were classified using the UNOS definitions. The recipients of both groups were comparable for most parameters, except of age - 40.4 [32;48] and 46.4 [37;56], p = 0.0023. To assess the survival rate, the Kaplan-Meyer analysis method and log-rank criterion were used.
Results: 1- and 5-year survival of recipients in group I was 99% (95% CI 98-100) for both periods, 1- and 5-year survival of recipients in group II was 96% (95% CI 92-99) for both periods, p=0.16 and p=0.33. When comparing the obtained results, no statistical differences had been found. The 1-year survival rate for renal grafts in group I was 97% (95% CI 94-99), in group II - 91% (95% CI 85-96), p=0.035; 5-year survival rates were 93% (95% CI 89-96) and 78% (95% CI 70-86), p=0.023, respectively. Thus, the 1- and 5-year survival of kidneys from standard donors was significantly better versus ECDs.
Conclusion: The survival rate of renal graft’s recipients from standard and extended criteria donors was high and didn’t differ. The long-term survival of kidney grafts was lower in ECDs group, but the use of this type of transplants is a perfectly acceptable way to overcome the critical shortage of donor organs.
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