Faculty Collaboration Database

A comparison between recipients receiving matched kidney and those receiving mismatched kidney from the same cadaver donor. Am J Transplant 2002 Apr;2(4):366-72

Date

07/18/2002

Pubmed ID

12118860

DOI

10.1034/j.1600-6143.2002.20413.x

Scopus ID

2-s2.0-0036556117 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

The optimal allocation of cadaveric kidneys for transplantation with reference to human leukocyte antigen (HLA) match and sharing these organs to a distant center remains controversial. The current analysis was performed using the United Network for Organ Sharing (UNOS) database for cadaveric kidney transplants (Tx) between 1988 and 1997. The graft survivals of zero-mismatch (matched) kidneys with the mate (mismatched) kidneys were compared. There were 2385 donors and 4770 Tx. Significant differences in recipient demographics between matched and mismatched Tx were: fewer African-American race (AA) in the matched group (9.0% vs. 21.9%), higher number of previous Tx (25.5% vs. 14.8%) and elevated mean cold ischemia time (24.0 vs. 22.2 h). Post-Tx dialysis requirements were similar (22.8% vs. 24.1%, p = 0.62) and matched kidneys had to travel more distance (920 vs. 232 miles). Using a Cox model, the matched group had a decreased relative hazard of graft failure of 23.0% (p = 0.0002) or 35% (p < 0.0001) with and without censoring for death. There was significantly better graft survival in the matched recipients in all pairs except AA (matched) and non-AA (mismatched). For older donors (> or = 50 years, n = 1508), the matched grafts survival was marginally significant (p =0.05). Matched kidneys have improved survival compared with the mismatched kidneys despite the longer distance traveled. The benefit of mismatched transplants was predominantly seen in non-AA.

Author List

Bresnahan BA, Johnson CP, McIntosh MJ, Stablein D, Hariharan S

Authors

Barbara A. Bresnahan MD Professor in the Medicine department at Medical College of Wisconsin
Christopher P. Johnson MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Cadaver
Female
Graft Rejection
Graft Survival
HLA Antigens
Histocompatibility
Humans
Kidney Transplantation
Male
Middle Aged
Organ Preservation
Proportional Hazards Models
Temperature
Time Factors
Tissue Donors
Transplantation, Homologous
Travel