A novel scheme for graft allocation in non-heart beating donor renal transplantation

被引：2
作者：
Laugharne, Matthew J. [1 ]
Clarke, Elaine [2 ]
Younie, Mary E. [3 ]
Johnson, Rachel J. [4 ]
Rudge, Christopher J. [4 ]
Pentlow, Barry D. [1 ]
Morgan, Justin D. [1 ]
Dudley, Christopher R. [2 ]
机构：
[1] N Bristol NHS Trust, Dept Surg, Bristol, Avon, England
[2] N Bristol NHS Trust, Dept Renal Med, Bristol, Avon, England
[3] N Bristol NHS Trust, Dept Immunol, Bristol, Avon, England
[4] UK Transplant Serv, Bristol BS10 5ND, Avon, England
来源：
TRANSPLANTATION | 2008年 / 85卷 / 11期
关键词：
renal transplantation; non-heart beating donor; donation after cardiac death; organ allocation;
D O I：
10.1097/TP.0b013e318172cab2
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Patients waiting more than 3 years for a renal transplant were ranked according to our novel Bristol and Region Allocation by Non-heart beating Donor Score (BRANDS). One kidney from 40 non-heart beating donors was allocated to the highest BRANDS long-waiter and the other kidney allocated according to the UK National Allocation Scheme (NAS). The scheme reduced the number of patients waiting more than 3 years by 20%. Despite longer dialysis time, greater sensitization and more human leukocyte antigen mismatches, BRANDS patients had equivalent 3-year graft survival (BRANDS 91%, NAS 97%, P = 0.264) and patient survival (BRANDS 94%, NAS 92%, P = 0.99). Results were similar to 242 synchronous recipients from heart-beating donors. Renal function was significantly lower in BRANDS recipients (40 vs. 62 mL/min/1.73 m(2), p < 0.0001). Transplanting long-waiting patients with kidneys from non-heart beating donors has reduced waiting times without compromising early outcomes. It is unclear if equivalent survival will be sustained in the long term.
引用
收藏
页码：1663 / 1667
页数：5
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