Comparison of Cadaveric Renal Allograft Survival Between Multiorgan Donors and Kidney Donors Alone

Jang, Hyuk Jai; Kim, Song Cheol; Kim, Suk Koo; Han, Duck Jong

Abstract

In cadaveric renal transplantation, the graft survival from multiorgan donor (MOD) and kidney donor alone (KDA) can be suspected to be different due to a different situation. In MOD, more complicated procurement procedure and least priority of kidney can be a negative impact on graft survival. While in KDA, poor donor status can be an negative factor for graft survival. We have evaluated the characteristics of MOD and KDA group, and analyzed to find out whether there is a disparity in graft survival between the two groups. Among the 137 cadaveric renal allografts from 1991 to 1997, 80 patients(58%) underwent renal allograft from MOD and 57(42%) from KDA. Because of the limited organ resources, we managed every donor carefully as a potential multiorgan donor and final decision to harvest multiorgans was made during the exploration. The average donor age of MOD was younger than that of KDA(26yr vs 32yr, p=0.02) and proportion of category A (donors who had spent less than 6 days in the ICU and had received dopamine less than 5 microgram/kg/min and had not experenced cardiac arrest) was higher in MOD(p=0.03). There were fewer recepients with the ABO minor mismatching in the MOD group (p=0.04). Mean cold ischemic time for both groups did not differ significantly (9.5 hr vs 8.1 hr, p=0.9). Postoperative ATN (33.8% vs 38.6%, p=0.6) and rejection (22.5% vs 24.6%, p=0.7) did not differ significantly in both groups. The one -and 5-year graft survival of MOD group were 88% and 85% compared with 89% and 84% in KDA group. From these results, we can conclude that graft survival did not show any difference between the two groups, regardless of multifactorial differences in renal allograft between MOD and KDA.