title: The outcome of kidney grafts from multiorgan donors and kidney only donors.
abstract: From 1988 to 1994, 15356 renal cadaveric transplantations have been performed within the Eurotransplant area (Austria, Belgium, Germany, Luxembourg and The Netherlands); 8746 kidneys were obtained from multiorgan donors and 6610 from kidney only donors. To evaluate the impact of the procurement policy, multiorgan donor (MOD) versus kidney only donor (KOD), on renal graft survival, an observational study has been performed. Multivariate analysis using Cox's proportional hazards model served to quantify the role of the procurement policy on renal graft survival after adjustment for other prognostic factors. The kidneys obtained from MODs had a significantly better graft survival at 1, 3, and 5 years after transplantation than the kidneys obtained from KODs (85%, 75%, and 58% versus 78%, 68%, and 46% (P=0.0001). In the Cox model, patients transplanted with a KOD kidney had a 1.28 times higher risk of losing their graft than patients transplanted with a MOD kidney. This benefit in graft survival for MOD kidneys could not be explained by the fact that the MODs were younger and male, and that UW was used as preservation solution. A plausible explanation is that MODs, on average, because of the nonrenal transplants, are better supervised. We expect that optimal donor management will contribute to a better outcome of all renal grafts.
authors.affiliation: Eurotransplant International Foundation, Leiden, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Smits
authors.forename: J
authors.initials: J
authors.lastname: De Meester
authors.forename: G G
authors.initials: GG
authors.lastname: Persijn
authors.forename: F H
authors.initials: FH
authors.lastname: Claas
authors.forename: H C
authors.initials: HC
authors.lastname: Van Houwelingen
mesh_terms: D000241:Adenosine; D000328:Adult; D000493:Allopurinol; D002102:Cadaver; D016572:Cyclosporine / Q000627:therapeutic use; D005060:Europe / Q000453:epidemiology; D005260:Female; D005978:Glutathione; D006084:Graft Rejection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006085:Graft Survival; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007328:Insulin; D016030:Kidney Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation; D019188:Organ Preservation Solutions; D011379:Prognosis; D016016:Proportional Hazards Models; D011640:Public Policy; D011887:Raffinose; D012996:Solutions; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D007328:Insulin; D019188:Organ Preservation Solutions; D012996:Solutions; C055206:University of Wisconsin-lactobionate solution; D000493:Allopurinol; D016572:Cyclosporine; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose