Seychelle Yohanna1, Kyla L Naylor2, Eric McArthur2, Ngan N Lam3,4, Peter C Austin5,6, Steven Habbous7, Megan K McCallum2, Michael Ordon8, Greg A Knoll9, Joseph S Kim5, Amit X Garg2,7,10. 1. Division of Nephrology, McMaster University, Hamilton, ON, Canada. 2. ICES, London, ON, Canada. 3. Division of Nephrology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 4. Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada. 5. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. 6. ICES, Toronto, ON, Canada. 7. Department of Epidemiology & Biostatistics, Western University, London, ON, Canada. 8. Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada. 9. Division of Nephrology, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada. 10. Division of Nephrology, Western University, London, ON, Canada.
Abstract
BACKGROUND: Consider a theoretical situation in which 2 patients with similar baseline characteristics receive a kidney transplant on the same day: 1 from a standard criteria deceased donor, the other from a living donor. Which kidney transplant will last longer? METHODS: We conducted a population-based cohort study using linked administrative healthcare databases from Ontario, Canada, from January 1, 2005, to March 31, 2014, to evaluate several posttransplant outcomes in individuals who received a kidney transplant from a standard criteria deceased donor (n = 1523) or from a living donor (n = 1373). We used PS weighting using overlap weights, a novel weighting method that emphasizes the population of recipients with the most overlap in baseline characteristics. RESULTS: Compared with recipients of a living donor, the rate of all-cause graft failure was not statistically higher for recipients of a standard criteria deceased donor (hazard ratio, 1.1; 95% confidence interval [CI], 0.8-1.6). Recipients of a standard criteria deceased donor, compared with recipients of a living donor had a higher rate of delayed graft function (23.6% versus 18.7%; odds ratio, 1.3; 95% CI, 1.0-1.6) and a longer length of stay for the kidney transplant surgery (mean difference, 1.7 d; 95% CI, 0.5-3.0). CONCLUSIONS: After accounting for many important donor and recipient factors, we failed to observe a large difference in the risk of all-cause graft failure for recipients of a standard criteria deceased versus living donor. Some estimates were imprecise, which meant we could not rule out the presence of smaller clinically important effects.
BACKGROUND: Consider a theoretical situation in which 2 patients with similar baseline characteristics receive a kidney transplant on the same day: 1 from a standard criteria deceased donor, the other from a living donor. Which kidney transplant will last longer? METHODS: We conducted a population-based cohort study using linked administrative healthcare databases from Ontario, Canada, from January 1, 2005, to March 31, 2014, to evaluate several posttransplant outcomes in individuals who received a kidney transplant from a standard criteria deceased donor (n = 1523) or from a living donor (n = 1373). We used PS weighting using overlap weights, a novel weighting method that emphasizes the population of recipients with the most overlap in baseline characteristics. RESULTS: Compared with recipients of a living donor, the rate of all-cause graft failure was not statistically higher for recipients of a standard criteria deceased donor (hazard ratio, 1.1; 95% confidence interval [CI], 0.8-1.6). Recipients of a standard criteria deceased donor, compared with recipients of a living donor had a higher rate of delayed graft function (23.6% versus 18.7%; odds ratio, 1.3; 95% CI, 1.0-1.6) and a longer length of stay for the kidney transplant surgery (mean difference, 1.7 d; 95% CI, 0.5-3.0). CONCLUSIONS: After accounting for many important donor and recipient factors, we failed to observe a large difference in the risk of all-cause graft failure for recipients of a standard criteria deceased versus living donor. Some estimates were imprecise, which meant we could not rule out the presence of smaller clinically important effects.
Authors: Ailish Nimmo; Nicholas Latimer; Gabriel C Oniscu; Rommel Ravanan; Dominic M Taylor; James Fotheringham Journal: Transpl Int Date: 2022-06-27 Impact factor: 3.842
Authors: Atit A Dharia; Michael Huang; Michelle M Nash; Niki Dacouris; Jeffrey S Zaltzman; G V Ramesh Prasad Journal: BMC Nephrol Date: 2022-03-05 Impact factor: 2.388