J Korean Soc Transplant.  2013 Dec;27(4):166-173. 10.4285/jkstn.2013.27.4.166.

Evaluation of the Korean Network for Organ Sharing Expanded Donor Criteria in Deceased Donor Renal Transplantation

Affiliations
  • 1Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. wh51cho@dsmc.or.kr
  • 2Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
  • 3Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 4Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
  • 5Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
  • 6Department of Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.

Abstract

BACKGROUND
This study was conducted in order to evaluate the propriety of expanded donor criteria in Korea and to identify the preoperative factors influencing allograft survival and function.
METHODS
We studied 404 patients who received deceased renal transplants from five transplantation centers of 2, 3 territory from 2000 to 2010. Differences in 1-year graft function, delayed graft function (DGF) rate, and graft survival rate between the standard criteria donor (SCD) and expanded criteria donor (ECD) were compared retrospectively. The preoperative factors influencing graft function and graft survival were analysed.
RESULTS
SCD showed significantly better 1-year graft function than ECD (P=0.011). No differences in 1-year acute rejection rate were observed between SCD (13.2%) and ECD (16.9%) (P=0.449). Significantly higher DGF rate was observed for ECD (25.4%) than for SCD (14.1%) (P=0.022). Graft type had no significant influence on 5-year graft survival (SCD 94.5% vs. ECD 93.7%) (P =0.835). Advanced donor age (P=0.001), donor hypertension history (P=0.047), high serum creatinine (P=0.002), and cerebral infarction as cause of death (P=0.004) had a negative influence on 1-year allograft function. Significantly low graft survival was observed for advanced donor age (P =0.002).
CONCLUSIONS
Graft function, DGF rates of ECD were poorer than those of SCD. Graft survival rate of ECD was comparable to that of SCD kidney. Korean Network for Organ Sharing expanded criteria may underestimate the organ quality of deceased kidney and modification may be needed in order to expand the potential donor pool through nationwide study.

Keyword

Kidney transplantation; Expanded criteria; Standard criteria; Deceased donor; Survival rate

MeSH Terms

Cause of Death
Cerebral Infarction
Creatinine
Delayed Graft Function
Graft Survival
Humans
Hypertension
Kidney
Kidney Transplantation*
Korea
Retrospective Studies
Survival Rate
Tissue Donors*
Transplantation, Homologous
Transplants
Creatinine

Figure

  • Fig. 1. Renal allograft survival rate according to donor criteria: standard criteria donor (SCD) versus expanded criteria donor (ECD).

  • Fig. 2. Influence of donor age on recipient allograft survival.

  • Fig. 3. Total of 71 patients were assorted as expanded criteria donor (ECD) by Korean Network for Organ Sharing (KONOS) criteria and only 27 patients (38.0%) of them were expanded donor by United Network for Organ Sharing (UNOS) criteria. Abbreviation: SCD, standard criteria donor.

  • Fig. 4. Kidney grade determined by Nyberg donor score in 71 patients of Korean Network for Organ Sharing expanded criteria donor.


Cited by  4 articles

Kidney Transplantation from Expanded Criteria Donor in Korea: It's Time to Have Our Own Criteria Based on Our Experiences
Shin-Seok Yang, Jae Berm Park
J Korean Soc Transplant. 2017;31(1):16-24.    doi: 10.4285/jkstn.2017.31.1.16.

Clinical Outcomes and Contributors in Contemporary Kidney Transplantation: Single Center Experience
Jae-Sung Ahn, Kyung Sun Park, Jongha Park, Hyun Chul Chung, Hojong Park, Sang Jun Park, Hong Rae Cho, Jong Soo Lee
J Korean Soc Transplant. 2017;31(4):182-192.    doi: 10.4285/jkstn.2017.31.4.182.

A Preliminary Study to Revise the Marginal Donor Criteria of KONOS in Deceased Donor Kidney Transplantation
Wooseong Huh
J Korean Soc Transplant. 2017;31(2):59-67.    doi: 10.4285/jkstn.2017.31.2.59.

Kidney Allocation: Present Status and Future Strategy
Yeong Hoon Kim
J Korean Soc Transplant. 2016;30(1):1-5.    doi: 10.4285/jkstn.2016.30.1.1.


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