2165 INCREASING THE KIDNEY DONOR POOL: ILLINOIS STATEWIDE EXPERIENCE COMPARING OUTCOMES AND CHARACTERISTICS OF DOUBLE KIDNEY TRANSPLANT ORGANS WITH THOSE DISCARDED – IS THERE ROOM TO GROW?

Le résumé fourni par la source

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation, Vascular Surgery II1 Apr 20102165 INCREASING THE KIDNEY DONOR POOL: ILLINOIS STATEWIDE EXPERIENCE COMPARING OUTCOMES AND CHARACTERISTICS OF DOUBLE KIDNEY TRANSPLANT ORGANS WITH THOSE DISCARDED – IS THERE ROOM TO GROW? Cory Hugen, Anthony Polcari, Ahmer Farooq, Ronald Skolek, Martin Mozes, Susan Hou, and John Milner Cory HugenCory Hugen Chicago, IL More articles by this author , Anthony PolcariAnthony Polcari Maywood, IL More articles by this author , Ahmer FarooqAhmer Farooq Maywood, IL More articles by this author , Ronald SkolekRonald Skolek Elmhurst, IL More articles by this author , Martin MozesMartin Mozes Elmhurst, IL More articles by this author , Susan HouSusan Hou Maywood, IL More articles by this author , and John MilnerJohn Milner Maywood, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2268AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The increasing number of patients waiting for transplant has provoked alternative strategies to expand the kidney donor pool. Pulsatile Perfusion (PP) combined with Double Kidney Transplantation (DKT) increases organ utilization. We report the total experience of DKT from Illinois and compare characteristics of kidneys utilized for DKT against those that were perfused, but discarded. METHODS Immediate and 1-year recipient outcomes for all patients undergoing DKT at transplant centers in the state of Illinois from January 2002-October 2009 were analyzed. The characteristics of the transplanted kidneys were then compared with available organs that were perfused, but discarded. Kidneys in both groups were recovered from Extended Criteria Donors (ECD) or Donation after Cardiac Death (DCD). Biopsy data, PP parameters, and pertinent donor historical data were compared between groups. RESULTS 60 recipients underwent DKT while 94 kidney pairs (188 kidneys) were discarded after PP. Of the recipients, 15(30%) had delayed graft function. Forty-one recipients (68%) had 1 year follow up data of whom 36 (88%) were alive off-dialysis, 1(2%) was alive on-dialysis, and 4(10%) were dead. Pre-implantation biopsy findings for the surviving 36 patients with functioning DKTs (72 renal units) demonstrated: Glomerulosclerosis- none 20(28%), mild 25(35%), moderate 23(32%) severe 4(5%); Interstitial Fibrosis- none 11(15%), mild 53(74%), moderate 8(11%); mean vascular hyalanosis was 14.7%(range: 0-71). Comparing biopsy results between utilized and discarded kidneys, only % vascular hyalinosis (14.7 vs. 18.5, p=0.042) was worse in the discard group. There were no differences in PP parameters between utilized and discarded kidneys. Additionally, there were no differences in donor history of HTN, DM, initial or final Cr between groups. Utilized kidneys actually had a higher mean age (62 vs. 57, p=<0.001) and lower mean initial GFR in the donor (76.9 vs. 87.4, p=0.008) compared with the discard group. CONCLUSIONS The shortage of organs in the United States has focused attention on maximizing organ utilization. Our results show favorable 1-year graft survival rates for DKT using ECD and DCD kidneys. Furthermore, the considerable overlap demonstrated between transplanted and discarded kidneys suggests that many discarded pairs could be utilized with similar results. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e842 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cory Hugen Chicago, IL More articles by this author Anthony Polcari Maywood, IL More articles by this author Ahmer Farooq Maywood, IL More articles by this author Ronald Skolek Elmhurst, IL More articles by this author Martin Mozes Elmhurst, IL More articles by this author Susan Hou Maywood, IL More articles by this author John Milner Maywood, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.