Anja Gallinat1, Sabine Leerhoff1, Andreas Paul1, Ernesto P Molmenti2, Maren Schulze1, Oliver Witzke3, Georgios C Sotiropoulos4. 1. Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany. 2. Department of Surgery, North Shore University Hospital, Manhasset, NY, USA. 3. Department of Nephrology, University Hospital Essen, Essen, Germany. 4. Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Hufelandstraße 55, 45122, Essen, Germany. georgios.sotiropoulos@uni-due.de.
Abstract
BACKGROUND: Elevated donor serum creatinine has been associated with inferior graft survival in kidney transplantation (KT). The aim of this study was to evaluate the impact of elevated donor serum creatinine on short and long-term outcomes and to determine possible ways to optimize the use of these organs. METHODS: All kidney transplants from 01-2000 to 12-2012 with donor creatinine ≥ 2 mg/dl were considered. Risk factors for delayed graft function (DGF) were explored with uni- and multivariate regression analyses. Donor and recipient data were analyzed with uni- and multivariate cox proportional hazard analyses. Graft and patient survival were calculated using the Kaplan-Meier method. RESULTS: Seventy-eight patients were considered. Median recipient age and waiting time on dialysis were 53 years and 5.1 years, respectively. After a median follow-up of 6.2 years, 63 patients are alive. 1, 3, and 5-year graft and patient survival rates were 92, 89, and 89 % and 96, 93, and 89 %, respectively. Serum creatinine level at procurement and recipient's dialysis time prior to KT were predictors of DGF in multivariate analysis (p = 0.0164 and p = 0.0101, respectively). Charlson comorbidity score retained statistical significance by multivariate regression analysis for graft survival (p = 0.0321). Recipient age (p = 0.0035) was predictive of patient survival by multivariate analysis. CONCLUSIONS: Satisfactory long-term kidney transplant outcomes in the setting of elevated donor serum creatinine ≥2 mg/dl can be achieved when donor creatinine is <3.5 mg/dl, and the recipient has low comorbidities, is under 56 years of age, and remains in dialysis prior to KT for <6.8 years.
BACKGROUND: Elevated donor serum creatinine has been associated with inferior graft survival in kidney transplantation (KT). The aim of this study was to evaluate the impact of elevated donor serum creatinine on short and long-term outcomes and to determine possible ways to optimize the use of these organs. METHODS: All kidney transplants from 01-2000 to 12-2012 with donorcreatinine ≥ 2 mg/dl were considered. Risk factors for delayed graft function (DGF) were explored with uni- and multivariate regression analyses. Donor and recipient data were analyzed with uni- and multivariate cox proportional hazard analyses. Graft and patient survival were calculated using the Kaplan-Meier method. RESULTS: Seventy-eight patients were considered. Median recipient age and waiting time on dialysis were 53 years and 5.1 years, respectively. After a median follow-up of 6.2 years, 63 patients are alive. 1, 3, and 5-year graft and patient survival rates were 92, 89, and 89 % and 96, 93, and 89 %, respectively. Serum creatinine level at procurement and recipient's dialysis time prior to KT were predictors of DGF in multivariate analysis (p = 0.0164 and p = 0.0101, respectively). Charlson comorbidity score retained statistical significance by multivariate regression analysis for graft survival (p = 0.0321). Recipient age (p = 0.0035) was predictive of patient survival by multivariate analysis. CONCLUSIONS: Satisfactory long-term kidney transplant outcomes in the setting of elevated donor serum creatinine ≥2 mg/dl can be achieved when donorcreatinine is <3.5 mg/dl, and the recipient has low comorbidities, is under 56 years of age, and remains in dialysis prior to KT for <6.8 years.
Authors: Richard Ugarte; Edward Kraus; Robert A Montgomery; James F Burdick; Lloyd Ratner; Mark Haas; Alan M Hawxby; Seth J Karp Journal: Transplantation Date: 2005-09-27 Impact factor: 4.939
Authors: Anja Gallinat; Cyril Moers; Jürgen Treckmann; Jacqueline M Smits; Henry G D Leuvenink; Rolf Lefering; Ernest van Heurn; Günter R Kirste; Jean-Paul Squifflet; Axel Rahmel; Jacques Pirenne; Rutger J Ploeg; Andreas Paul Journal: Nephrol Dial Transplant Date: 2012-07-26 Impact factor: 5.992
Authors: Anja Gallinat; Georgios C Sotiropoulos; Oliver Witzke; Jürgen W Treckmann; Ernesto P Molmenti; Andreas Paul; Udo Vester Journal: Pediatr Transplant Date: 2013-03
Authors: Katharina Schütte-Nütgen; Markus Finke; Sabrina Ehlert; Gerold Thölking; Hermann Pavenstädt; Barbara Suwelack; Daniel Palmes; Ralf Bahde; Raphael Koch; Stefan Reuter Journal: PLoS One Date: 2019-03-13 Impact factor: 3.240