title: Cold ischemic time is critical in outcomes of expanded criteria donor renal transplantation.
abstract: The outcomes of expanded criteria donor (ECD) kidneys have been reported to be inferior compared with standard criteria donor (SCD) kidneys. However, the graft survival rate of ECD is not so inferior to SCD in Korea. The purposes of this study were to compare the outcomes of ECD kidneys with SCD kidneys and identify the influencing factors. We retrospectively studied 143 deceased donor transplants from August 2006 to June 2010. The patients were divided into SCD (n = 117) and ECD (n = 26) by UNOS criteria. The one- and three-yr graft survival rates of SCD and ECD (99.1% and 94.4% vs. 100% and 92.9%, respectively, p = 0.15) were not significantly different between groups. The mean cold ischemic time (CIT) was 3.8 ± 2.2 h. When compared the outcome of ECD kidneys with data reported by Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients (OPTN/SRTR) (one- and three-yr graft survival rate: 86.7% and 73.2%), the graft survival rate of our center was superior. In OPTN/SRTR data, transplant with CIT shorter than 11 h was only 20%. The outcomes of ECD grafts are outstanding and comparable with SCD grafts in our center, and the only distinguishing factor is markedly short CIT. Finishing the allocation before organ recovery and immediate operations after recovery could shorten the CIT.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Suh Min
authors.initials: SM
authors.lastname: Kim
authors.forename: Sanghyun
authors.initials: S
authors.lastname: Ahn
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Min
authors.forename: Daedo
authors.initials: D
authors.lastname: Park
authors.forename: Taejin
authors.initials: T
authors.lastname: Park
authors.forename: Seung Kee
authors.initials: SK
authors.lastname: Min
authors.forename: Sang Joon
authors.initials: SJ
authors.lastname: Kim
authors.forename: Jongwon
authors.initials: J
authors.lastname: Ha
mesh_terms: D000328:Adult; D050377:Cold Ischemia; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000401:mortality*; D006085:Graft Survival; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000401:mortality*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000592:standards*; D055815:Young Adult