title: Early and Long-Term Outcomes of Kidney Grafts Procured From Multiple-Organ Donors and Kidney-Only Donors.
abstract: BACKGROUND
  The deceased-donor kidney pool consists of 2 different populations: multiple-organ donors (MOD) and kidney donors alone (KDA). In MOD, more complicated procedure and lowest priority for kidney procurement may affect graft survival. On the other hand, poor donor status and higher comorbidity are more frequent in KDA transplants. The aim of this study was to provide detailed characteristics of the 2 groups of kidney donors (KDA vs MOD) in our center and to analyze the potential influence of the donor type on the early and long-term kidney graft function and recipient outcome.
  
  
  METHODS
  We performed a retrospective analysis of 729 first cadaveric kidney transplant recipients: 499 of them received the organ from MOD, 230 from KDA.
  
  
  RESULTS
  The frequency of delayed graft function (DGF) was higher in KDA than in MOD transplants (38.7 vs 25.1%; P < .001). Multivariate logistic regression analysis revealed that donor age, KDA, and early acute rejection independently increased the risk of DGF occurrence, whereas recipient age and cold ischemia time increased the risk of primary graft nonfunction. Kidney excretory function was significantly worse in KDA up to 10 years after transplantation. There were no differences in kidney graft and patient survivals, frequency of proteinuria, acute rejection, and cytomegalovirus episodes, and post-transplantation diabetes.
  
  
  CONCLUSIONS
  (1) The use of a kidney from KDA negatively affects early and late kidney graft function compared with MOD. (2) The long-term kidney graft and patient survivals are not affected by the type of organ procurement.
authors: Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Francuska, Poland.
authors: H
authors: H
authors: Cholewa
authors: Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Francuska, Poland.
authors: J
authors: J
authors: Chronowska
authors: Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Francuska, Poland.
authors: U
authors: U
authors: Kukla
authors: Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Francuska, Poland.
authors: T
authors: T
authors: Goc
authors: Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Francuska, Poland.
authors: E
authors: E
authors: Lieber
authors: Department of Nephrology, Transplantation, and Internal Medicine, Medical University of Silesia, Katowice, Francuska, Poland. Electronic address: uryniusz@wp.pl.
authors: A
authors: A
authors: Kolonko
authors: Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Francuska, Poland.
authors: G
authors: G
authors: Budziński
authors: Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Francuska, Poland.
authors: J
authors: J
authors: Ziaja
authors: Department of Nephrology, Transplantation, and Internal Medicine, Medical University of Silesia, Katowice, Francuska, Poland.
authors: A
authors: A
authors: Wiecek
authors: Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Francuska, Poland.
authors: L
authors: L
authors: Cierpka
mesh_terms: D000328:Adult; D000367:Age Factors; D002102:Cadaver; D050377:Cold Ischemia; D051799:Delayed Graft Function / Q000209:etiology*; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*