title: Regional vs. national renal sharing organizations: pros and cons.
abstract: Delayed graft function, defined as the need of dialysis in the first week after transplantation, neither due to immunological nor technical causes, determines a poor outcome of renal grafts. Delayed graft function is related to the cold ischemia time, which is shorter in local allocation programs. These, however, do not assure an optimal HLA-A,B,DR matching that can be provided by national allocation organizations. We reviewed 160 cadaveric kidney grafts performed in our local transplant network. Owing to the long waiting list caused by organ shortage, we were able to ensure both a high-grade histocompatibility and short cold ischemia times. The mean HLA-B,DR mismatch was 1.17. Cold ischemia time was < 24 h in 85% of cases. The incidence of DGF was 23.1%. In our experience a regional sharing program in the case of organ shortage provides good graft outcome (86.9% graft survival at 1 yr) with low incidence of delayed graft function.
authors.affiliation: Department of Renal Transplantation, Careggi Hospital, Florence, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Bertoni
authors.forename: M
authors.initials: M
authors.lastname: Carmellini
authors.forename: S
authors.initials: S
authors.lastname: Bandini
authors.forename: P
authors.initials: P
authors.lastname: Tosi
authors.forename: M
authors.initials: M
authors.lastname: Zanazzi
authors.forename: A
authors.initials: A
authors.lastname: Rosati
authors.forename: F
authors.initials: F
authors.lastname: Pradella
authors.forename: V
authors.initials: V
authors.lastname: Fossombroni
authors.forename: P
authors.initials: P
authors.lastname: Rindi
authors.forename: G
authors.initials: G
authors.lastname: Rizzo
authors.forename: P
authors.initials: P
authors.lastname: Mattiuz
authors.forename: F
authors.initials: F
authors.lastname: Mosca
authors.forename: M
authors.initials: M
authors.lastname: Salvadori
mesh_terms: D002102:Cadaver; D015925:Cryopreservation / Q000379:methods; D006085:Graft Survival; D015234:HLA-A Antigens / Q000032:analysis; D015235:HLA-B Antigens / Q000032:analysis; D006684:HLA-DR Antigens / Q000032:analysis; D015276:Health Care Rationing; D006648:Histocompatibility; D006801:Humans; D015994:Incidence; D007511:Ischemia; D007558:Italy; D016030:Kidney Transplantation / Q000502:physiology; D012041:Regional Medical Programs; D006435:Renal Dialysis; D015996:Survival Rate; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens