Reasons for non-use of recovered kidneys

The effect of donor glomerulosclerosis and creatinine clearance on graft survival

Erick B. Edwards, Marc P. Posner, Daniel Maluf, H. Myron Kauffman

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Background. In 2000, the United Network for Organ Sharing/Organ Procurement and Transplantation Network Registry reported 540 recovered kidneys were discarded because of biopsy results, and 210 were discarded because of poor organ function. We compared the percentage of glomerulosclerosis (GS) and creatinine clearance (CrCl) of both discarded and transplanted cadaveric kidneys and examined their effect on graft survival and function. Methods. The cohort consisted of all cadaveric kidneys (n=3,444) with reported biopsy results between October 25, 1999 and December 31, 2001. Graft survival was calculated by univariate and multivariate models. Results. Fifty-one percent of discarded kidneys had GS of less than 20%, 27% had a CrCl greater than 80 mL/min, and 15% (129 kidneys) had both GS less than 20% and a CrCl of greater than 80 mL/min. Univariate analyses of kidneys with less than or equal to 20% GS revealed no difference in 1-year graft survival when the CrCl was greater than or less than or equal to 80 mL/min. When GS was greater than 20%, 1-year graft survival of kidneys with a CrCl of greater than 80 mL/min was significantly greater than that of kidneys with a CrCl of less than or equal to 80 mL/min. Multivariate results showed no significant difference in relative risk of graft loss with GS greater than 20% versus less than or equal to 20% when the CrCl was either 50 or 80 mL/min. With both GS less than or equal to 20% and greater than 20%, serum creatinine at 1 year was significantly lower in kidneys with CrCl greater 80 mL/min. Conclusions. Calculated donor CrCl does, and percentage GS on donor kidney biopsies does not, correlate well with 1-year graft survival and function, and percentage GS should not be used as the sole criterion for discarding recovered cadaveric kidneys.

Original languageEnglish (US)
Pages (from-to)1411-1415
Number of pages5
JournalTransplantation
Volume77
Issue number9 SUPPL.
DOIs
StatePublished - May 15 2004
Externally publishedYes

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Graft Survival
Creatinine
Kidney
Biopsy
Tissue and Organ Procurement
Organ Transplantation
Registries
Transplants

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Reasons for non-use of recovered kidneys : The effect of donor glomerulosclerosis and creatinine clearance on graft survival. / Edwards, Erick B.; Posner, Marc P.; Maluf, Daniel; Kauffman, H. Myron.

In: Transplantation, Vol. 77, No. 9 SUPPL., 15.05.2004, p. 1411-1415.

Research output: Contribution to journalArticle

Edwards, Erick B. ; Posner, Marc P. ; Maluf, Daniel ; Kauffman, H. Myron. / Reasons for non-use of recovered kidneys : The effect of donor glomerulosclerosis and creatinine clearance on graft survival. In: Transplantation. 2004 ; Vol. 77, No. 9 SUPPL. pp. 1411-1415.
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abstract = "Background. In 2000, the United Network for Organ Sharing/Organ Procurement and Transplantation Network Registry reported 540 recovered kidneys were discarded because of biopsy results, and 210 were discarded because of poor organ function. We compared the percentage of glomerulosclerosis (GS) and creatinine clearance (CrCl) of both discarded and transplanted cadaveric kidneys and examined their effect on graft survival and function. Methods. The cohort consisted of all cadaveric kidneys (n=3,444) with reported biopsy results between October 25, 1999 and December 31, 2001. Graft survival was calculated by univariate and multivariate models. Results. Fifty-one percent of discarded kidneys had GS of less than 20{\%}, 27{\%} had a CrCl greater than 80 mL/min, and 15{\%} (129 kidneys) had both GS less than 20{\%} and a CrCl of greater than 80 mL/min. Univariate analyses of kidneys with less than or equal to 20{\%} GS revealed no difference in 1-year graft survival when the CrCl was greater than or less than or equal to 80 mL/min. When GS was greater than 20{\%}, 1-year graft survival of kidneys with a CrCl of greater than 80 mL/min was significantly greater than that of kidneys with a CrCl of less than or equal to 80 mL/min. Multivariate results showed no significant difference in relative risk of graft loss with GS greater than 20{\%} versus less than or equal to 20{\%} when the CrCl was either 50 or 80 mL/min. With both GS less than or equal to 20{\%} and greater than 20{\%}, serum creatinine at 1 year was significantly lower in kidneys with CrCl greater 80 mL/min. Conclusions. Calculated donor CrCl does, and percentage GS on donor kidney biopsies does not, correlate well with 1-year graft survival and function, and percentage GS should not be used as the sole criterion for discarding recovered cadaveric kidneys.",
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T2 - The effect of donor glomerulosclerosis and creatinine clearance on graft survival

AU - Edwards, Erick B.

AU - Posner, Marc P.

AU - Maluf, Daniel

AU - Kauffman, H. Myron

PY - 2004/5/15

Y1 - 2004/5/15

N2 - Background. In 2000, the United Network for Organ Sharing/Organ Procurement and Transplantation Network Registry reported 540 recovered kidneys were discarded because of biopsy results, and 210 were discarded because of poor organ function. We compared the percentage of glomerulosclerosis (GS) and creatinine clearance (CrCl) of both discarded and transplanted cadaveric kidneys and examined their effect on graft survival and function. Methods. The cohort consisted of all cadaveric kidneys (n=3,444) with reported biopsy results between October 25, 1999 and December 31, 2001. Graft survival was calculated by univariate and multivariate models. Results. Fifty-one percent of discarded kidneys had GS of less than 20%, 27% had a CrCl greater than 80 mL/min, and 15% (129 kidneys) had both GS less than 20% and a CrCl of greater than 80 mL/min. Univariate analyses of kidneys with less than or equal to 20% GS revealed no difference in 1-year graft survival when the CrCl was greater than or less than or equal to 80 mL/min. When GS was greater than 20%, 1-year graft survival of kidneys with a CrCl of greater than 80 mL/min was significantly greater than that of kidneys with a CrCl of less than or equal to 80 mL/min. Multivariate results showed no significant difference in relative risk of graft loss with GS greater than 20% versus less than or equal to 20% when the CrCl was either 50 or 80 mL/min. With both GS less than or equal to 20% and greater than 20%, serum creatinine at 1 year was significantly lower in kidneys with CrCl greater 80 mL/min. Conclusions. Calculated donor CrCl does, and percentage GS on donor kidney biopsies does not, correlate well with 1-year graft survival and function, and percentage GS should not be used as the sole criterion for discarding recovered cadaveric kidneys.

AB - Background. In 2000, the United Network for Organ Sharing/Organ Procurement and Transplantation Network Registry reported 540 recovered kidneys were discarded because of biopsy results, and 210 were discarded because of poor organ function. We compared the percentage of glomerulosclerosis (GS) and creatinine clearance (CrCl) of both discarded and transplanted cadaveric kidneys and examined their effect on graft survival and function. Methods. The cohort consisted of all cadaveric kidneys (n=3,444) with reported biopsy results between October 25, 1999 and December 31, 2001. Graft survival was calculated by univariate and multivariate models. Results. Fifty-one percent of discarded kidneys had GS of less than 20%, 27% had a CrCl greater than 80 mL/min, and 15% (129 kidneys) had both GS less than 20% and a CrCl of greater than 80 mL/min. Univariate analyses of kidneys with less than or equal to 20% GS revealed no difference in 1-year graft survival when the CrCl was greater than or less than or equal to 80 mL/min. When GS was greater than 20%, 1-year graft survival of kidneys with a CrCl of greater than 80 mL/min was significantly greater than that of kidneys with a CrCl of less than or equal to 80 mL/min. Multivariate results showed no significant difference in relative risk of graft loss with GS greater than 20% versus less than or equal to 20% when the CrCl was either 50 or 80 mL/min. With both GS less than or equal to 20% and greater than 20%, serum creatinine at 1 year was significantly lower in kidneys with CrCl greater 80 mL/min. Conclusions. Calculated donor CrCl does, and percentage GS on donor kidney biopsies does not, correlate well with 1-year graft survival and function, and percentage GS should not be used as the sole criterion for discarding recovered cadaveric kidneys.

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SN - 0041-1337

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