HYPOTHESIS: The use of kidneys from deceased donors considered at increased infectious risk represents a strategy to increase the donor pool. DESIGN: Single-institution longitudinal observational study. SETTING: Tertiary care center. PATIENTS: Fifty patients who gave special informed consent to receive Centers for Disease Control and Prevention high-risk (CDCHR) donor kidneys were followed up by serial testing for viral transmission after transplantation. Nucleic acid testing for human immunodeficiency virus, hepatitis B virus, and hepatitis C virus was performed on all high-risk donors before transplantation. Outcomes of CDCHR kidney recipients were compared with outcomes of non-high-risk (non-HR) kidney recipients. MAIN OUTCOME MEASURES: New viral transmission, graft function, and waiting list time. RESULTS: No recipient seroconversion was detected during a median follow-up period of 11.3 months. Compared with non-HR donors, CDCHR donors were younger (mean [SD] age, 35 [11] vs 43 [18] years, P = .01), fewer were expanded criteria donors (2.0% vs 24.8%, P < .001), and fewer had a terminal creatinine level exceeding 2.5 mg/dL (4.0% vs 8.8%, P = .002). The median creatinine levels at 1 year after transplantation were 1.4 (interquartile range, 1.2-1.7) mg/dL for CDCHR recipients and 1.4 (interquartile range, 1.1-1.9) mg/dL for non-HR recipients (P = .4). Willingness to accept a CDCHR kidney significantly shortened the median waiting list time (274 vs 736 days, P < .001). CONCLUSIONS: We show safe use of CDCHR donor kidneys and good 1-year graft function. With continued use of these organs and careful follow-up care, we will be better able to gauge donor risk and match it to recipient need to expand the donor pool and optimize patient benefit.
HYPOTHESIS: The use of kidneys from deceased donors considered at increased infectious risk represents a strategy to increase the donor pool. DESIGN: Single-institution longitudinal observational study. SETTING: Tertiary care center. PATIENTS: Fifty patients who gave special informed consent to receive Centers for Disease Control and Prevention high-risk (CDCHR) donor kidneys were followed up by serial testing for viral transmission after transplantation. Nucleic acid testing for human immunodeficiency virus, hepatitis B virus, and hepatitis C virus was performed on all high-risk donors before transplantation. Outcomes of CDCHR kidney recipients were compared with outcomes of non-high-risk (non-HR) kidney recipients. MAIN OUTCOME MEASURES: New viral transmission, graft function, and waiting list time. RESULTS: No recipient seroconversion was detected during a median follow-up period of 11.3 months. Compared with non-HR donors, CDCHR donors were younger (mean [SD] age, 35 [11] vs 43 [18] years, P = .01), fewer were expanded criteria donors (2.0% vs 24.8%, P < .001), and fewer had a terminal creatinine level exceeding 2.5 mg/dL (4.0% vs 8.8%, P = .002). The median creatinine levels at 1 year after transplantation were 1.4 (interquartile range, 1.2-1.7) mg/dL for CDCHR recipients and 1.4 (interquartile range, 1.1-1.9) mg/dL for non-HR recipients (P = .4). Willingness to accept a CDCHR kidney significantly shortened the median waiting list time (274 vs 736 days, P < .001). CONCLUSIONS: We show safe use of CDCHR donor kidneys and good 1-year graft function. With continued use of these organs and careful follow-up care, we will be better able to gauge donor risk and match it to recipient need to expand the donor pool and optimize patient benefit.
Authors: Courtenay M Holscher; Mary G Bowring; Christine E Haugen; Sheng Zhou; Allan B Massie; Sommer E Gentry; Dorry L Segev; Jacqueline M Garonzik Wang Journal: Transplantation Date: 2019-10 Impact factor: 4.939
Authors: Mary G Bowring; Ashton A Shaffer; Allan B Massie; Andrew Cameron; Niraj Desai; Mark Sulkowski; Jacqueline Garonzik-Wang; Dorry L Segev Journal: Am J Transplant Date: 2019-04-09 Impact factor: 8.086
Authors: Mary G Bowring; Courtenay M Holscher; Sheng Zhou; Allan B Massie; Jacqueline Garonzik-Wang; Lauren M Kucirka; Sommer E Gentry; Dorry L Segev Journal: Am J Transplant Date: 2017-12-05 Impact factor: 8.086
Authors: Shanti M Seaman; Sarah E Van Pilsum Rasmussen; Anh Q Nguyen; Samantha E Halpern; Susan You; Madeleine M Waldram; Saad K Anjum; Mary Grace Bowring; Abimereki D Muzaale; Darin B Ostrander; Diane Brown; Allan B Massie; Aaron A R Tobian; Macey L Henderson; Faith E Fletcher; Burke Smith; Ada Chao; Nishita Gorupati; Katya Prakash; Saima Aslam; Dong H Lee; Varvara Kirchner; Timothy L Pruett; Ghady Haidar; Kailey Hughes; Maricar Malinis; Sonya Trinh; Dorry L Segev; Jeremy Sugarman; Christine M Durand Journal: J Acquir Immune Defic Syndr Date: 2020-09-01 Impact factor: 3.771