Abstract
Improved outcomes have been associated with various methods of size matching between expanded criteria (ECD) donors and recipients. A novel method for improved functional based matching was developed utilizing manipulation of Cockcroft-Gault estimated creatinine clearances for donor and recipient. We hypothesized that optimal clearance-based matches would have superior outcomes for both immediate graft function and long-term graft survival. For the analysis, recipients of ECD kidneys in the Scientific Registry of Transplant Recipients (SRTR) transplanted between October 1, 1987 and August 31, 2011 were included. Univariate and multivariate analyses predicted the hazard ratio of graft failure and the odds ratio of requiring dialysis within the first week. A total of 25,640 ECD kidney transplants were analyzed. On multivariate analysis, higher creatinine clearance match ratio (CCMR) was associated with increased graft failure and odds of requiring dialysis within the first week (comparing highest ratio quintile versus lowest ratio quintile: HR 1.43, p < 0.001; OR 2.08, p < 0.001). This study suggests that ECD kidneys have improved outcomes when the recipient/donor CCMR is optimized.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 738-746 |
| Number of pages | 9 |
| Journal | Clinical Transplantation |
| Volume | 29 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 1 2015 |
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Keywords
- Creatinine clearance
- End-stage renal disease
- Extended criteria donor
- Kidney transplantation
- Surgical outcomes
ASJC Scopus subject areas
- Transplantation
Cite this
ECD kidney transplantation outcomes are improved when matching donors to recipients using a novel creatinine clearance match ratio (CCMR). / Anderson, Jamie; Steiner, Robert W.; Mekeel, Kristin L.; Chang, David C.; Hemming, Alan W.; Halldorson, Jeffrey B.
In: Clinical Transplantation, Vol. 29, No. 9, 01.09.2015, p. 738-746.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - ECD kidney transplantation outcomes are improved when matching donors to recipients using a novel creatinine clearance match ratio (CCMR)
AU - Anderson, Jamie
AU - Steiner, Robert W.
AU - Mekeel, Kristin L.
AU - Chang, David C.
AU - Hemming, Alan W.
AU - Halldorson, Jeffrey B.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Improved outcomes have been associated with various methods of size matching between expanded criteria (ECD) donors and recipients. A novel method for improved functional based matching was developed utilizing manipulation of Cockcroft-Gault estimated creatinine clearances for donor and recipient. We hypothesized that optimal clearance-based matches would have superior outcomes for both immediate graft function and long-term graft survival. For the analysis, recipients of ECD kidneys in the Scientific Registry of Transplant Recipients (SRTR) transplanted between October 1, 1987 and August 31, 2011 were included. Univariate and multivariate analyses predicted the hazard ratio of graft failure and the odds ratio of requiring dialysis within the first week. A total of 25,640 ECD kidney transplants were analyzed. On multivariate analysis, higher creatinine clearance match ratio (CCMR) was associated with increased graft failure and odds of requiring dialysis within the first week (comparing highest ratio quintile versus lowest ratio quintile: HR 1.43, p < 0.001; OR 2.08, p < 0.001). This study suggests that ECD kidneys have improved outcomes when the recipient/donor CCMR is optimized.
AB - Improved outcomes have been associated with various methods of size matching between expanded criteria (ECD) donors and recipients. A novel method for improved functional based matching was developed utilizing manipulation of Cockcroft-Gault estimated creatinine clearances for donor and recipient. We hypothesized that optimal clearance-based matches would have superior outcomes for both immediate graft function and long-term graft survival. For the analysis, recipients of ECD kidneys in the Scientific Registry of Transplant Recipients (SRTR) transplanted between October 1, 1987 and August 31, 2011 were included. Univariate and multivariate analyses predicted the hazard ratio of graft failure and the odds ratio of requiring dialysis within the first week. A total of 25,640 ECD kidney transplants were analyzed. On multivariate analysis, higher creatinine clearance match ratio (CCMR) was associated with increased graft failure and odds of requiring dialysis within the first week (comparing highest ratio quintile versus lowest ratio quintile: HR 1.43, p < 0.001; OR 2.08, p < 0.001). This study suggests that ECD kidneys have improved outcomes when the recipient/donor CCMR is optimized.
KW - Creatinine clearance
KW - End-stage renal disease
KW - Extended criteria donor
KW - Kidney transplantation
KW - Surgical outcomes
UR - http://www.scopus.com/inward/record.url?scp=84940963627&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84940963627&partnerID=8YFLogxK
U2 - 10.1111/ctr.12555
DO - 10.1111/ctr.12555
M3 - Article
C2 - 25918902
AN - SCOPUS:84940963627
VL - 29
SP - 738
EP - 746
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 9
ER -