Post-Transplant Graft Function and Survival Outcomes in Recipients of Standard Versus Marginal Cadaveric Donor Kidneys: A Single Center Experience Over a 10-Year Period

Öz

Kidney transplantation is considered the best therapeutic option for end-stage renal disease. This study aimed to evaluate post-transplant graft function and survival outcomes in recipients of standard versus marginal cadaveric donor kidneys. A total of 30 cadaveric kidney transplantations performed with standard donor kidneys were retrospectively evaluated. Data on donor and recipient characteristics, kidney donor risk index (KDRI) and kidney donor profile index (KDPI) values, serum creatinine levels (up to 5th post-transplant year), delayed graft function, acute rejection status, graft and recipient survival rates were recorded. SCD and ECD groups were similar in terms of acute rejection (5.3% vs. 0.0%, p=1.000) and delayed graft function (42.1 vs. 54.5%, p=0.510) rates. Graft survival was significantly higher in the SCD group vs. ECD group (100.0% vs. 72.7%, p=0.041), while two the groups were similar in terms of recipient survival rates (94.7% vs. 90.9%, p=1.000). Graft loss occurred within the first three years in the ECD group. Higher serum creatinine levels were noted in the ECD vs. SCD group for the 1st month, 6th month and 1st year (p=0.042, p=0.015 and p=0.022, respectively) but not in the 3rd and 5th post-transplant years. Donor age (r=0.606 and r=0.602, respectively), KDRI (r=0.737 and r=0.759, respectively) and KDPI (r=0.590 and r=0.593, respectively) were significantly correlated with death-censored and total graft loss (p<0.001 for each). Our findings, although associated with relatively poorer transplantation outcomes, highlight that, marginal cadaveric donor kidneys expand the donor pool for kidney transplantation, are superior alternative to dialysis.

Anahtar Kelimeler

• Kidney
• Transplantation
• marginal donor

Standart ve Marjinal Kadavra Verici Böbrek Alıcılarında Transplantasyon Sonrası Greft Fonksiyonu ve Sağkalım Sonuçları: 10 Yıllık Tek Merkez Deneyimi

Öz

Böbrek nakli, son dönem böbrek yetmezliği için en iyi tedavi seçeneği olarak kabul edilmektedir. Bu çalışmada standart (SCD) ve marjinal (ECD) kadavra verici böbreklerden yapılan nakillerde, transplantasyon sonrası greft fonksiyonu ve sağkalım sonuçları değerlendirildi. Toplam 30 kadaverik böbrek nakli retrospektif olarak incelendi. Donör ve alıcı özellikleri, böbrek donör risk indeksi (KDRI), böbrek donör profil indeksi (KDPI), serum kreatinin düzeyleri (5. yıla kadar), gecikmiş greft fonksiyonu, akut rejeksiyon durumu, greft ve alıcı sağkalım oranları kaydedildi. SCD ve ECD grupları akut rejeksiyon (sırasıyla %5,3 ve %0, p=1,000) ve gecikmiş greft fonksiyonu (%42,1 ve %54,5, p=0,510) açısından benzerdi. Greft sağkalımı SCD grubunda anlamlı derecede daha yüksekti (%100,0’a karşı %72,7, p=0,041). Ancak alıcı sağkalımı açısından fark saptanmadı (%94,7 ve %90,9, p=1,000). Greft kaybı ECD grubunda ilk 3 yıl içinde meydana geldi. Serum kreatinin düzeyleri ECD grubunda 1. ay, 6. ay ve 1. yılda daha yüksekti (p=0,042; p=0,015; p=0,022), ancak 3. ve 5. yıllarda fark görülmedi. Donör yaşı (r=0,606 ve r=0,602), KDRI (r=0,737 ve r=0,759) ve KDPI (r=0,590 ve r=0,593) hem ölüm dışı hem de toplam greft kaybı ile anlamlı ilişkili bulundu (her biri için p<0,001). Bulgularımız, transplantasyon sonuçlarının görece daha zayıf olmasına rağmen, marjinal kadavra verici böbreklerin donör havuzunu genişlettiğini ve diyalize kıyasla üstün bir seçenek olduğunu göstermektedir.

Anahtar Kelimeler

• Böbrek
• organ nakli
• marjinal donör

Kaynakça

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