Assfalg, Volker ORCID: 0000-0002-6907-5524, Miller, Gregor ORCID: 0000-0002-4281-4905, Stocker, Felix, van Meel, Marieke, Groenevelt, Tiny, Tieken, Ineke, Ankerst, Donna, Renders, Lutz, Novotny, Alexander, Hartmann, Daniel, Jell, Alissa, Rahmel, Axel, Wahba, Roger, Muehlfeld, Anja, Bouts, Antonia, Ysebaert, Dirk, Globke, Brigitta, Jacobs-Tulleneers-Thevissen, Daniel ORCID: 0000-0001-5758-9547, Piros, Laszlo, Stippel, Dirk, Heller, Katharina, Eisenberger, Ute, van Laecke, Steven, Weimer, Rolf, Rosenkranz, Alexander R., Berger, Stefan, Fischer, Lutz, Kliem, Volker, Vondran, Florian, Sester, Urban, Schneeberger, Stefan, Harth, Ana ORCID: 0000-0002-1551-9214, Kuypers, Dirk, Fuegger, Reinhold, Arnol, Miha, Christiaans, Maarten, Weinmann-Menke, Julia, Krueger, Bernd, Hilbrands, Luuk ORCID: 0000-0002-4935-9765, Banas, Bernhard ORCID: 0000-0003-2076-2195, Hakenberg, Oliver, Minnee, Robert, Schwenger, Vedat, Heyne, Nils, van Zuilen, Arjan, Reindl-Schwaighofer, Roman, Lopau, Kai, Hueser, Norbert and Heemann, Uwe (2022). Kidney Transplantation After Rescue Allocation-the Eurotransplant Experience: A Retrospective Multicenter Outcome Analysis. Transplantation, 106 (6). S. 1215 - 1227. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1534-6080

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Abstract

Background. At Eurotransplant (ET), kidneys are transferred to rescue allocation (RA), whenever the standard allocation (SA) algorithms Eurotransplant Kidney Allocation System (ETKAS) and Eurotransplant Senior Program (ESP) fail. We analyzed the outcome of RA. Methods. Retrospective patient clinical and demographic characteristics association analyses were performed with graft outcomes for 2422 recipients of a deceased donor renal transplantation (DDRT) after RA versus 25 481 after SA from 71 centers across all ET countries from 2006 to 2018. Results. Numbers of DDRTs after RA increased over the time, especially in Germany. RA played a minor role in ESP versus ETKAS (2.7% versus 10.4%). RA recipients and donors were older compared with SA recipients and donors, cold ischemia times were longer, waiting times were shorter, and the incidence of primary nonfunction was comparable. Among ETKAS recipients, HLA matching was more favorable in SA (mean 3.7 versus 2.5). In multivariate modeling, the incidence of graft loss in ETKAS recipients was reduced in RA compared with SA (subdistribution hazard ratio, 0.80; 95% confidence interval [0.70-0.91], P < 0.001), whereas other outcomes (mortality, death with functioning graft (DwFG)) were not significantly different. None of the 3 outcomes were significantly different when comparing RA with SA within the ESP program. Conclusions. Facing increased waiting times and mortality on dialysis due to donor shortage, this study reveals encouragingly positive DDRT outcomes following RA. This supports the extension of RA to more patients and as an alternative tool to enable transplantation in patients in countries with prohibitively long waiting times or at risk of deterioration.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Assfalg, VolkerUNSPECIFIEDorcid.org/0000-0002-6907-5524UNSPECIFIED
Miller, GregorUNSPECIFIEDorcid.org/0000-0002-4281-4905UNSPECIFIED
Stocker, FelixUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Meel, MariekeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Groenevelt, TinyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tieken, InekeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ankerst, DonnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Renders, LutzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Novotny, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hartmann, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jell, AlissaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rahmel, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wahba, RogerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muehlfeld, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bouts, AntoniaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ysebaert, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Globke, BrigittaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jacobs-Tulleneers-Thevissen, DanielUNSPECIFIEDorcid.org/0000-0001-5758-9547UNSPECIFIED
Piros, LaszloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stippel, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heller, KatharinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eisenberger, UteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Laecke, StevenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weimer, RolfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosenkranz, Alexander R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berger, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischer, LutzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kliem, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vondran, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sester, UrbanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schneeberger, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Harth, AnaUNSPECIFIEDorcid.org/0000-0002-1551-9214UNSPECIFIED
Kuypers, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fuegger, ReinholdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arnol, MihaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Christiaans, MaartenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weinmann-Menke, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krueger, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hilbrands, LuukUNSPECIFIEDorcid.org/0000-0002-4935-9765UNSPECIFIED
Banas, BernhardUNSPECIFIEDorcid.org/0000-0003-2076-2195UNSPECIFIED
Hakenberg, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Minnee, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schwenger, VedatUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heyne, NilsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Zuilen, ArjanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reindl-Schwaighofer, RomanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lopau, KaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hueser, NorbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heemann, UweUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-699037
DOI: 10.1097/TP.0000000000003964
Journal or Publication Title: Transplantation
Volume: 106
Number: 6
Page Range: S. 1215 - 1227
Date: 2022
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1534-6080
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
COLD ISCHEMIA TIME; GRAFT FAILURE; MORTALITY; RECIPIENTS; RISK; FRAILTY; ASSOCIATION; PREDICTOR; SURVIVAL; DIALYSISMultiple languages
Immunology; Surgery; TransplantationMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69903

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