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KMID : 0361120130270040166
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Korean Journal of Transplantation
2013 Volume.27 No. 4 p.166 ~ p.173
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Evaluation of the Korean Network for Organ Sharing Expanded
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Park Ui-Jun
Cho Won-Hyun
Kim Hyoung-Tae
Kim Min-Young
Kim Yong-Lim
Kim Chan-Duck
Cho Jang-Hee
Kim Young-Hoon
Park Suk-Joo
Chung Sang-Young
Choi Soo-Jin-Na
Lee Ho-Kyun
Park Sung-Kwang
Lee Sik
Yu Hee-Chul
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Abstract
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Background: This study was conducted in order to evaluate the propriety of expanded donor criteria in Korea and to identify the preoperative factors influencing allograft survival and function.
Methods: We studied 404 patients who received deceased renal transplants from five transplantation centers of 2, 3 territory from 2000 to 2010. Differences in 1-year graft function, delayed graft function (DGF) rate, and graft survival rate between the standard criteria donor (SCD) and expanded criteria donor (ECD) were compared retrospectively. The preoperative factors influencing graft function and graft survival were analysed.
Results: SCD showed significantly better 1-year graft function than ECD (P=0.011). No differences in 1-year acute rejection rate were observed between SCD (13.2%) and ECD (16.9%) (P=0.449). Significantly higher DGF rate was observed for ECD (25.4%) than for SCD (14.1%) (P=0.022). Graft type had no significant influence on 5-year graft survival (SCD 94.5% vs. ECD 93.7%) (P =0.835). Advanced donor age (P=0.001), donor hypertension history (P=0.047), high serum creatinine (P=0.002), and cerebral infarction as cause of death (P=0.004) had a negative influence on 1-year allograft function. Significantly low graft survival was observed for advanced donor age (P =0.002).
Conclusions: Graft function, DGF rates of ECD were poorer than those of SCD. Graft survival rate of ECD was comparable to that of SCD kidney. Korean Network for Organ Sharing expanded criteria may underestimate the organ quality of deceased kidney and modification may be needed in order to expand the potential donor pool through nationwide study.
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KEYWORD
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Kidney transplantation, Expanded criteria, Standard criteria, Deceased donor, Survival rate
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