Cadaveric Renal Transplantation, before and after KONOS System (Single Center Report)

Chung, Un Kyung; Cho, Won Hyun; Kim, Hyoung Tae; Koo, Ja Hyun; Joo, Sin Heon; Hwang, Eun Ah; Han, Seung Yeup; Park, Sung Bae; Kim, Hyun Chul

Abstract

INTRODUCTION
Comparing with living donor renal transplantation, cadaveric renal transplantation is usually performed as an emergency procedure and has prolonged preservation time and increased incidence of delayed graft function. Korean Network for Organ Sharing (KONOS) was launched from February 2000 to manage the organ transplantation in Korea and expected to increase donor organs supply and an effective organ allocation. PURPOSE: In order to compare the result of cadaveric renal transplantation before and after KONOS system, 108 cadaveric renal transplants performed in Dongsan hospital until October 2003 were reviewed and analyzed.
METHODS
Donors and recipients were divided into two groups (group 1; transplantation performed before KONOS, group 2; transplantation after KONOS) and their characteristics and results were analyzed retrospectively. RESULTS: Among donor factors, number of multi-organ procurement increased (23.1% vs 78.6%), and use of inotrophic agent decreased (63% vs 46%) significantly after KONOS, however cold preservation time was not changed even after KONOS system. Procured organs per one donor in our hospital was increased from 2.25 to 2.65. Increased recipient age (from 30.1 to 41.9 years old), more chance to diabetic patient and decreasing number of HLA mismatching (4.6 to 3.9) were considered as a result of KONOS allocation system. However, early results including incidence of acute rejection episode and delayed graft function, and serum creatinine level at the end of one year were no statistic differences. The number of early graft loss were decreased up to 2 years after transplantation.
CONCLUSION
Renal transplantation from cadaveric donor after KONOS resulted in lower early graft loss but increased waiting time due to organ shortage is a serious problem to be solved in the future.