Influence of Deceased Donor and Pretransplant Recipient Parameters on Early Overall Kidney Graft-Survival in Germany
Background. Scarcity of grafts for kidney transplantation (KTX) caused an increased consideration of deceased donors with substantial risk factors. There is no agreement on which ones are detrimental for overall graft-survival. Therefore, we investigated in a nationwide multicentre study the impact...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2015/307230 |
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| author | Carl-Ludwig Fischer-Fröhlich Marcus Kutschmann Johanna Feindt Irene Schmidtmann Günter Kirste Nils R. Frühauf Ulrike Wirges Axel Rahmel Christina Schleicher |
| author_facet | Carl-Ludwig Fischer-Fröhlich Marcus Kutschmann Johanna Feindt Irene Schmidtmann Günter Kirste Nils R. Frühauf Ulrike Wirges Axel Rahmel Christina Schleicher |
| author_sort | Carl-Ludwig Fischer-Fröhlich |
| collection | DOAJ |
| description | Background. Scarcity of grafts for kidney transplantation (KTX) caused an increased consideration of deceased donors with substantial risk factors. There is no agreement on which ones are detrimental for overall graft-survival. Therefore, we investigated in a nationwide multicentre study the impact of donor and recipient related risks known before KTX on graft-survival based on the original data used for allocation and graft acceptance. Methods. A nationwide deidentified multicenter study-database was created of data concerning kidneys donated and transplanted in Germany between 2006 and 2008 as provided by the national organ procurement organization (Deutsche Stiftung Organtransplantation) and BQS Institute. Multiple Cox regression (significance level 5%, hazard ratio [95% CI]) was conducted (n=4411, isolated KTX). Results. Risk factors associated with graft-survival were donor age (1.020 [1.013–1.027] per year), donor size (0.985 [0.977–0.993] per cm), donor’s creatinine at admission (1.002 [1.001–1.004] per µmol/L), donor treatment with catecholamine (0.757 [0.635–0.901]), and reduced graft-quality at procurement (1.549 [1.217–1.973]), as well as recipient age (1.012 [1.003–1.021] per year), actual panel reactive antibodies (1.007 [1.002–1.011] per percent), retransplantation (1.850 [1.484–2.306]), recipient’s cardiovascular comorbidity (1.436 [1.212–1.701]), and use of IL2-receptor antibodies for induction (0.741 [0.619–0.887]). Conclusion. Some donor characteristics persist to impact graft-survival (e.g., age) while the effect of others could be mitigated by elaborate donor-recipient match and care. |
| format | Article |
| id | doaj-art-2aa637f04bae4825bde1fd79ba3eee2f |
| institution | OA Journals |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-2aa637f04bae4825bde1fd79ba3eee2f2025-08-20T02:04:09ZengWileyJournal of Transplantation2090-00072090-00152015-01-01201510.1155/2015/307230307230Influence of Deceased Donor and Pretransplant Recipient Parameters on Early Overall Kidney Graft-Survival in GermanyCarl-Ludwig Fischer-Fröhlich0Marcus Kutschmann1Johanna Feindt2Irene Schmidtmann3Günter Kirste4Nils R. Frühauf5Ulrike Wirges6Axel Rahmel7Christina Schleicher8Deutsche Stiftung Organtransplantation, Region Baden-Württemberg, Kriegerstraße 6, 70192 Stuttgart, GermanyBQS Institute for Quality and Patient Safety, Kanzlerstraße 4, 40472 Düsseldorf, GermanyMVZ Anaesthesio Nordrhein, Hans-Günther-Sohl-Straße 6-10, 40235 Düsseldorf, GermanyInstitut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Obere Zahlbacher Straße 69, 55131 Mainz, GermanyMedizinische Fakultät, Albert Ludwigs Universität Freiburg, Hebelstraße 29, 79104 Freiburg, GermanyLandesärztekammer Niedersachsen, Berliner Allee 20, 30175 Hannover, GermanyDeutsche Stiftung Organtransplantation, Region Nordrhein-Westfalen, Lindenallee 29-41, 45127 Essen, GermanyDeutsche Stiftung Organtransplantation, Deutschherrnufer 52, 60594 Frankfurt am Main, GermanyDeutsche Stiftung Organtransplantation, Region Baden-Württemberg, Kriegerstraße 6, 70192 Stuttgart, GermanyBackground. Scarcity of grafts for kidney transplantation (KTX) caused an increased consideration of deceased donors with substantial risk factors. There is no agreement on which ones are detrimental for overall graft-survival. Therefore, we investigated in a nationwide multicentre study the impact of donor and recipient related risks known before KTX on graft-survival based on the original data used for allocation and graft acceptance. Methods. A nationwide deidentified multicenter study-database was created of data concerning kidneys donated and transplanted in Germany between 2006 and 2008 as provided by the national organ procurement organization (Deutsche Stiftung Organtransplantation) and BQS Institute. Multiple Cox regression (significance level 5%, hazard ratio [95% CI]) was conducted (n=4411, isolated KTX). Results. Risk factors associated with graft-survival were donor age (1.020 [1.013–1.027] per year), donor size (0.985 [0.977–0.993] per cm), donor’s creatinine at admission (1.002 [1.001–1.004] per µmol/L), donor treatment with catecholamine (0.757 [0.635–0.901]), and reduced graft-quality at procurement (1.549 [1.217–1.973]), as well as recipient age (1.012 [1.003–1.021] per year), actual panel reactive antibodies (1.007 [1.002–1.011] per percent), retransplantation (1.850 [1.484–2.306]), recipient’s cardiovascular comorbidity (1.436 [1.212–1.701]), and use of IL2-receptor antibodies for induction (0.741 [0.619–0.887]). Conclusion. Some donor characteristics persist to impact graft-survival (e.g., age) while the effect of others could be mitigated by elaborate donor-recipient match and care.http://dx.doi.org/10.1155/2015/307230 |
| spellingShingle | Carl-Ludwig Fischer-Fröhlich Marcus Kutschmann Johanna Feindt Irene Schmidtmann Günter Kirste Nils R. Frühauf Ulrike Wirges Axel Rahmel Christina Schleicher Influence of Deceased Donor and Pretransplant Recipient Parameters on Early Overall Kidney Graft-Survival in Germany Journal of Transplantation |
| title | Influence of Deceased Donor and Pretransplant Recipient Parameters on Early Overall Kidney Graft-Survival in Germany |
| title_full | Influence of Deceased Donor and Pretransplant Recipient Parameters on Early Overall Kidney Graft-Survival in Germany |
| title_fullStr | Influence of Deceased Donor and Pretransplant Recipient Parameters on Early Overall Kidney Graft-Survival in Germany |
| title_full_unstemmed | Influence of Deceased Donor and Pretransplant Recipient Parameters on Early Overall Kidney Graft-Survival in Germany |
| title_short | Influence of Deceased Donor and Pretransplant Recipient Parameters on Early Overall Kidney Graft-Survival in Germany |
| title_sort | influence of deceased donor and pretransplant recipient parameters on early overall kidney graft survival in germany |
| url | http://dx.doi.org/10.1155/2015/307230 |
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