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Presenter: Besher, Al Attar, Riyadh, Saudi Arabia
Authors: Besher Al Attar, Faissal A.M. Shaheen, Muhammad Ziad Souqiyyeh, Abdulla Al Sayyari, Zayed Ibrahim
Diseased Kidney Transplantation from Expanded Criteria Donors
Besher Al Attar1, Faissal A.M. Shaheen1, Muhammad Ziad Souqiyyeh1, Abdulla Al Sayyari1, Zayed Ibrahim1
1Medical Department, Saudi Center for Organ Transplantation, Riyadh, Saudi Arabia
{figure1}OBJECTIVE: To identify and analyze the use of Expanded Criteria Donors (ECD) and the outcome of kidney transplantation in the Kingdom of Saudi Arabia.
METHODS: This is a retrospective study of all deceased donor transplantation from the year 2008 to 2010 investigating the impact on graft, patient survival and graft function of ECD kidneys compared to Standard Criteria Donors (SCD).{figure1}
RESULTS: Out of the 433 kidney transplants in the year 2008-2010, the number of ECD kidneys transplanted were 68 (16%), out of which 7 kidneys were from > 60 years old donors; 43 kidneys from serum creatinine > 133 umol/L or 50-59 years old with CVA/HTN and 18 kidneys were from donors with serum creatinine doubled at harvesting with cases of CVA/HTN. Moreover, it showed significant difference in the mean age group (39 years vs. 48 years). Furthermore, as the causes of brain insult, 38% of SCD were due to trauma while only 1 case (.02%) for ECD. There was increase number of days from the mean period of transplantation to discharge from 19 days for SCD and 32 days with ECD. The mean serum creatinine at discharge was doubled between the 2 groups. In comparison kidney recipients, who had delayed graft function also doubled between SCD 16% and ECD 36%. On the other hand, episodes of acute rejection are significantly increased from 5% in SCD to 20% in ECD group.{figure2}
CONCLUSION: The use of Expanded Criteria Donors is an acceptable method to use in specified category for kidney transplantation in Saudi Arabia. The outcome of marginal kidney transplantation is comparable to international data.
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