Universität zu Köln

Echterdiek, Fabian ORCID: 0000-0001-7239-4959, Tilgener, Constantin, Dippon, Juergen, Kitterer, Daniel, Scheder-Bieschin, Justus, Paul, Gregor ORCID: 0000-0002-1075-4362, Ott, Matthias, Humke, Ulrich, Schwenger, Vedat and Latus, Joerg (2022). Impact of the explanting surgeon's impression of donor arteriosclerosis on outcome of kidney transplantations from donors aged >= 65 years. Langenbecks Arch. Surg., 407 (2). S. 727 - 738. NEW YORK: SPRINGER. ISSN 1435-2451

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Abstract

Purpose Careful donor selection is important for kidney transplantations (KT) from suboptimal donors aged >= 65 years. Several tools such as histopathological assessment of preimplant biopsies have been shown to predict allograft survival and can be applied for selection. Whether the explanting surgeon's appraisal is associated with outcomes of KTs from suboptimal donors is unknown. Methods We compared outcomes of KTs from >= 65-year-old deceased donors performed at our centre between 1999 and 2018 for which grading of macroscopic 'donor arteriosclerosis' (n=104) and 'organ quality' (n=208) as judged by the explanting surgeon and documented on the Eurotransplant kidney organ report was available. Results No association was observed between degree of macroscopic donor arteriosclerosis and death-censored graft survival in univariable or multivariable regression analyses. Compared to KTs from donors with no/mild arteriosclerosis, KTs from donors with moderate/severe arteriosclerosis were associated with a significantly impaired allograft function 3 months, 1 year and 3 years after transplantation (e.g. at 3 years: 176.8 mu mol/l vs 137.0 mu mol/l, P=0.003). Following multivariable regression analysis, these differences remained significant at 3 months and 3 years after KT. No association was observed between degree of macroscopic arteriosclerosis and mortality or primary non-function as well as no consistent association with delayed graft function and histological arteriosclerosis. Assessment of 'organ quality' was not associated with outcomes. Conclusion Our data suggest that the explanting surgeon's assessment of donor arteriosclerosis is associated with allograft function. Larger studies and better standardization of kidney inspection after explantation are required to further explore the impact of surgeon's appraisal in KT.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Echterdiek, Fabian UNSPECIFIED orcid.org/0000-0001-7239-4959 UNSPECIFIED Tilgener, Constantin UNSPECIFIED UNSPECIFIED UNSPECIFIED Dippon, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Kitterer, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheder-Bieschin, Justus UNSPECIFIED UNSPECIFIED UNSPECIFIED Paul, Gregor UNSPECIFIED orcid.org/0000-0002-1075-4362 UNSPECIFIED Ott, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Humke, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwenger, Vedat UNSPECIFIED UNSPECIFIED UNSPECIFIED Latus, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-578329
DOI:	10.1007/s00423-021-02383-7
Journal or Publication Title:	Langenbecks Arch. Surg.
Volume:	407
Number:	2
Page Range:	S. 727 - 738
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1435-2451
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EUROTRANSPLANT SENIOR PROGRAM; RENAL-TRANSPLANTATION; GRAFT-SURVIVAL; BIOPSY; EXPERIENCE; RECIPIENTS; PATIENT; OLDER Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57832