2013 - ISODP 2013 Congress


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Oral Presentation 16 on Organ Allocation

32.6 - Kidney Transplantation from Deceased Donors with Terminal Creatinine > 3.0

Presenter: Richard D., Hasz, Philadelphia, United States
Authors: Richard D. Hasz, Howard M. Nathan, Sharon M. West

Kidney Transplantation from Deceased Donors with Terminal Creatinine > 3.0

Richard D. Hasz1, Howard M. Nathan1, Sharon M. West1

1Gift of Life Donor Program, Philadelphia, PA, United States

Purpose: Demonstrate that kidneys from donors with creatinine > 3.0 can be utilized for transplantation.

Method: Analysis of organ donors recovered over an 18-year period (January 1995- December 2012) was performed. Kidney utilization & transplant outcomes were evaluated for donors with terminal creatinine > 3.0 from whom at least one kidney was recovered with intent to transplant. Kidney graft survival was evaluated at 6 months, 1 yr, 3 yrs and 5 yrs post-transplant using the Kaplan-Meier method.

Result: 6,392 organ donors were recovered during the study period & 397 (6.21%) had a terminal creatinine > 3.0. Of the 5,908 kidney donors recovered, 208 (3.52%) had terminal creatinine > 3.0. A total of 410 kidneys were recovered and 233 (57%) were utilized for transplant from these donors. The mean donor age for kidney donors with high terminal creatinine was 37 yrs (r = 6–80) & the mean donor age for organ donors that did not become kidney donors was 50 yrs (r = 0.25–78). The ATN rate was 61% and median graft survival was 6.4 years, with 90% graft survival at 6 months, 87% at 1 yr, 71% at 3 yrs and 61% at 5 yrs. Kidney recovery & utilization by terminal creatinine is summarized below.

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Conclusion: Donors with creatinine > 3.0 have a higher ATN rate but acceptable graft survival and warrant further evaluation & should not necessarily be eliminated from the limited renal donor pool. Evaluation of donor age & terminal creatinine can assist in donor selection.

Figure 1


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