Management of patients on the waiting list for deceased donor kidney transplantation.
BACKGROUND
Although the number of wait-listed patients for deceased donor kidney transplantation has been continuously increasing in Korea, no standard guidelines exist for their management.


METHODS
We retrospectively analyzed the medical records of our 1,231 wait-listed patients between 2000 and 2010.


RESULTS
The time to transplantation of the 201 recipients was 51.9 ± 31.2 months. Ninety-seven patients died while waiting. Diabetic or older patients have increased among new registrants; however, <50% of them have undergone regular screening for malignancy or cardiovascular diseases. Patients with regular screening were more likely to get a chance to receive a transplant (P = .016). Malignancy was newly diagnosed in 26 patients (2.1%) and reversible cardiac ischemia was detected in 9.7%. The presence of anti-HLA antibodies was strongly associated with a lower transplantation rate, whereas blood type O was not. Although use of expanded criteria donor (ECD) kidneys increased, many patients avoided them.


CONCLUSIONS
It is necessary to improve management programs for wait-listed patients by establishing comorbidity screening and ECD education.
Transplantation Center, Seoul National University Hospital, Seoul, Korea.
M G
MG
Kim
H
H
Ro
Y J
YJ
Kim
H C
HC
Park
J C
JC
Jeong
H J
HJ
Jeon
H
H
Kim
M W
MW
Park
K-H
KH
Oh
Y S
YS
Kim
C
C
Ahn
J
J
Yang
D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003955:Diagnostic Tests, Routine; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000276:immunology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D014850:Waiting Lists / Q000401:mortality; D055815:Young Adult
D006680:HLA Antigens; D007518:Isoantibodies