Assfalg, Volker and Miller, Gregor and Stocker, Felix and van Meel, Marieke and Groenevelt, Tiny and Tieken, Ineke and Ankerst, Donna and Renders, Lutz and Novotny, Alexander and Hartmann, Daniel and Jell, Alissa and Rahmel, Axel and Wahba, Roger and Muehlfeld, Anja and Bouts, Antonia and Ysebaert, Dirk and Globke, Brigitta and Jacobs-Tulleneers-Thevissen, Daniel and Piros, Laszlo and Stippel, Dirk and Heller, Katharina and Eisenberger, Ute and van Laecke, Steven and Weimer, Rolf and Rosenkranz, Alexander R. and Berger, Stefan and Fischer, Lutz and Kliem, Volker and Vondran, Florian and Sester, Urban and Schneeberger, Stefan and Harth, Ana and Kuypers, Dirk and Fuegger, Reinhold and Arnol, Miha and Christiaans, Maarten and Weinmann-Menke, Julia and Krueger, Bernd and Hilbrands, Luuk and Banas, Bernhard and Hakenberg, Oliver and Minnee, Robert and Schwenger, Vedat and Heyne, Nils and van Zuilen, Arjan and Reindl-Schwaighofer, Roman and Lopau, Kai and Hueser, Norbert and Heemann, Uwe (2022) Kidney Transplantation After Rescue Allocation-the Eurotransplant Experience: A Retrospective Multicenter Outcome Analysis. TRANSPLANTATION, 106 (6). pp. 1215-1226. ISSN 0041-1337, 1534-6080
Full text not available from this repository. (Request a copy)Abstract
Background. At Eurotransplant (ET), kidneys are transferred to "rescue allocation" (RA), whenever the standard allocation (SA) algorithms Eurotransplant Kidney Allocation System (ETKAS) and Eurotransplant Senior Program (ESP) fail. We analyzed the outcome of RA. Methods. Retrospective patient clinical and demographic characteristics association analyses were performed with graft outcomes for 2422 recipients of a deceased donor renal transplantation (DDRT) after RA versus 25 481 after SA from 71 centers across all ET countries from 2006 to 2018. Results. Numbers of DDRTs after RA increased over the time, especially in Germany. RA played a minor role in ESP versus ETKAS (2.7% versus 10.4%). RA recipients and donors were older compared with SA recipients and donors, cold ischemia times were longer, waiting times were shorter, and the incidence of primary nonfunction was comparable. Among ETKAS recipients, HLA matching was more favorable in SA (mean 3.7 versus 2.5). In multivariate modeling, the incidence of graft loss in ETKAS recipients was reduced in RA compared with SA (subdistribution hazard ratio, 0.80; 95% confidence interval [0.70-0.91], P < 0.001), whereas other outcomes (mortality, death with functioning graft (DwFG)) were not significantly different. None of the 3 outcomes were significantly different when comparing RA with SA within the ESP program. Conclusions. Facing increased waiting times and mortality on dialysis due to donor shortage, this study reveals encouragingly positive DDRT outcomes following RA. This supports the extension of RA to more patients and as an alternative tool to enable transplantation in patients in countries with prohibitively long waiting times or at risk of deterioration.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COLD ISCHEMIA TIME; GRAFT FAILURE; MORTALITY; RECIPIENTS; RISK; FRAILTY; ASSOCIATION; PREDICTOR; SURVIVAL; DIALYSIS; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Nephrologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 19 Sep 2023 10:39 |
| Last Modified: | 19 Sep 2023 10:39 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58818 |
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