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Analysis of local versus imported expanded criteria donor kidneys: A single‐center experience with 497 ECD kidney transplants
Author(s) -
Khan Muhammad A.,
ElHennawy Hany,
Farney Alan C.,
Rogers Jeffrey,
Orlando Giuseppe,
ReevesDaniel Amber,
Palanisamy Amudha,
Gautreaux Michael,
Iskandar Samy,
Doares William,
Kaczmorski Scott,
Stratta Robert J.
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13029
Subject(s) - medicine , single center , kidney , urology , kidney transplantation , renal function , surgery , incidence (geometry) , physics , optics
Background The value of importing expanded criteria donor ( ECD ) kidneys is uncertain. Methods We retrospectively reviewed our single‐center experience with ECD kidney transplants ( KT ). Results Over 12.8 years, we performed 497 ECD KT s including 247 local and 250 imported from other donor service areas. The import ECD group had more donors (16% vs 9%) ≥ age 70, more zero human leukocyte antigen mismatches (14% vs 2%), more KT s with a cold ischemia time >30 hours (46% vs 19%), and fewer kidneys managed with pump preservation (78% vs 92%, all P ≤.05) compared to the local ECD group. Mean Kidney Donor Profile Index were 80% import vs 84% local. With a mean follow‐up of 55 months, actual patient and graft survival rates were 71% and 58% in import vs 76% and 58% in local ECD KT s, respectively. Death‐censored graft survival rates were 70% in import vs 69% in local ECD KT s. Delayed graft function occurred in 28% import vs 23% local ECD KT s ( P =NS) whereas the incidence of primary nonfunction was slightly higher with import ECD kidneys (4.8% vs 2.4%, P =.23). Conclusions Midterm outcomes are remarkably similar for import vs local ECD KT s, suggesting that broader sharing of ECD kidneys may improve utilization without compromising outcomes.