Comparative study between kidney transplantation with deceased donor expanded criteria and donor standard criteria in a single center in Brazil

Abstract Introduction: Kidney transplants with expanded criteria donor have been associated with improved patient survival compared to those who remain on dialysis. Objective: To compare renal function and survival of the kidney graft of deceased donor with expanded criteria and standard criteria over a year in a single transplant center. Methods: 255 kidney transplant recipients with deceased donor were included in the study between the years 2011 to 2013 and they were separated into two groups according to the type of donor (expanded criteria donor - ECD - and standard criteria donor - SCD). Results: 231 deceased donor transplants (90.6%) were performed with standard criteria donor (SCD) and 24 (9.4%) with expanded criteria donor (ECD). There was no difference in the prevalence of delayed graft function - DGF - (62.9% vs. 70.8%; p = 0.44). Expanded criteria donor group had lower glomerular filtration rate (GFR) at the end of the 1st year (56.8 ± 26.9 vs. 76.9 ± 23.7; p = 0.001). Patient survival was significantly lower in the ECD group, but the graft survival was not different after death-censored analysis. Conclusion: The ECD group was associated with significantly lower levels of GFR during the first year of transplant and a lower patient survival at the 1st year when compared to the SCD.

摘要及引言：与仍接受维持透析的患者相比，采用扩大标准供体（expanded criteria donor, ECD）实施的肾移植可改善患者的生存结局。
研究目的：在单个移植中心中，对比死亡供体来源的扩大标准供体肾移植与标准供体（standard criteria donor, SCD）肾移植在术后1年内的肾功能与移植肾存活率。
研究方法：纳入2011年至2013年间接受死亡供体肾移植的255名受者，根据供体类型分为两组：扩大标准供体（ECD）组与标准供体（SCD）组。
研究结果：本研究共完成231例标准供体（SCD）肾移植（占比90.6%），24例扩大标准供体（ECD）肾移植（占比9.4%）。两组患者的移植肾功能延迟恢复（delayed graft function, DGF）发生率无显著差异（62.9% vs. 70.8%; p = 0.44）。术后1年时，扩大标准供体组患者的肾小球滤过率（glomerular filtration rate, GFR）显著低于标准供体组（56.8 ± 26.9 vs. 76.9 ± 23.7; p = 0.001）。扩大标准供体组的患者生存率显著降低，但经死亡校正分析后，两组移植肾存活率无显著差异。
研究结论：与标准供体组相比，扩大标准供体组患者在肾移植术后1年内的肾小球滤过率水平显著更低，且术后1年的患者生存率也更低。