title: Kidney transplantation from 1119 deceased donors in Finland, 1991 to 2003: impact of donor factors.
abstract: We assessed the effect of donor factors on the recovery and quality of cadaveric kidney transplant function. During 1991 to 2003, 2006 kidney grafts were derived from 1119 heart-beating donors in Finland. The annual mean age of donors increased from 33 to 46 years, with a significant decrease in the proportion of high-energy trauma and gunshot wounds and with an increased proportion of donors with coronary disease, hypertension, or cardiopulmonary resuscitation and surgical/radiological interventions before death. The transplant team's share of kidney retrievals increased from 50% to nearly 100%. In uni- and multivariate analyses all these factors had significant effects on the onset and quality of early graft function; however, this effect practically vanished by 1 year posttransplant. Of all studied donor factors, only donor cytomegalovirus (CMV) status significantly affected long-term survival, with donor CMV-positive grafts having 5% worse survival at 5 years. The 1-year graft survival improved from 90.9% to 96.2% and mean 1-year creatinine decreased from 121 micromol/L to 109 micromol/L during these 13 years, showing that the worsening trends in donors quality were compensated by improvements in other aspects of the process.
authors.affiliation: Surgical Hospital, Helsinki University Hospital, Kasarmikatu 11-13, 00130 Helsinki, Finland. Lauri.Kyllonen@hus.fi
authors.forename: L
authors.initials: L
authors.lastname: Kyllönen
authors.forename: J
authors.initials: J
authors.lastname: Kahu
authors.forename: L
authors.initials: L
authors.lastname: Kyllönen
authors.forename: K
authors.initials: K
authors.lastname: Salmela
mesh_terms: D017677:Age Distribution; D000704:Analysis of Variance; D002423:Cause of Death; D005260:Female; D005387:Finland; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors / Q000706:statistics & numerical data* / Q000600:supply & distribution