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01-12-2016 | ORIGINAL ARTICLE

Kidney transplantation from deceased donors with elevated serum creatinine

Authors: Anja Gallinat, Sabine Leerhoff, Andreas Paul, Ernesto P. Molmenti, Maren Schulze, Oliver Witzke, Georgios C. Sotiropoulos

Published in: Langenbeck's Archives of Surgery | Issue 8/2016

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.

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Title: Kidney transplantation from deceased donors with elevated serum creatinine
Authors: Anja Gallinat
Sabine Leerhoff
Andreas Paul
Ernesto P. Molmenti
Maren Schulze
Oliver Witzke
Georgios C. Sotiropoulos
Publication date: 01-12-2016
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 8/2016
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-016-1445-9

At a glance: The STEP trials

Springer Medicine

Kidney transplantation from deceased donors with elevated serum creatinine

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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