Management of patients on the waiting list for deceased donor kidney transplantation

Transplant Proc. 2012 Jan;44(1):66-71. doi: 10.1016/j.transproceed.2011.12.020.

Abstract

Background: Although the number of wait-listed patients for deceased donor kidney transplantation has been continuously increasing in Korea, no standard guidelines exist for their management.

Methods: We retrospectively analyzed the medical records of our 1,231 wait-listed patients between 2000 and 2010.

Results: The time to transplantation of the 201 recipients was 51.9 ± 31.2 months. Ninety-seven patients died while waiting. Diabetic or older patients have increased among new registrants; however, <50% of them have undergone regular screening for malignancy or cardiovascular diseases. Patients with regular screening were more likely to get a chance to receive a transplant (P = .016). Malignancy was newly diagnosed in 26 patients (2.1%) and reversible cardiac ischemia was detected in 9.7%. The presence of anti-HLA antibodies was strongly associated with a lower transplantation rate, whereas blood type O was not. Although use of expanded criteria donor (ECD) kidneys increased, many patients avoided them.

Conclusion: It is necessary to improve management programs for wait-listed patients by establishing comorbidity screening and ECD education.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Comorbidity
  • Diagnostic Tests, Routine
  • Female
  • HLA Antigens / immunology
  • Histocompatibility
  • Humans
  • Isoantibodies / blood
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation* / immunology
  • Logistic Models
  • Male
  • Middle Aged
  • Neoplasms / diagnosis
  • Neoplasms / epidemiology
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Republic of Korea
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Survival Analysis
  • Time Factors
  • Tissue Donors / supply & distribution*
  • Treatment Outcome
  • Waiting Lists* / mortality
  • Young Adult

Substances

  • HLA Antigens
  • Isoantibodies