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Renal Transplantation
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Which Renal Transplant Candidates Should Accept Marginal Kidneys in Exchange for a Shorter Waiting Time on Dialysis?

Jesse D. Schold and Herwig-Ulf Meier-Kriesche
CJASN May 2006, 1 (3) 532-538; DOI: https://doi.org/10.2215/CJN.01130905
Jesse D. Schold
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Herwig-Ulf Meier-Kriesche
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    Figure 1.

    Projected life expectancy after ESRD onset by recipient age and treatment modality. Life expectancies are calculated from time of ESRD onset and incorporate the mortality rates associated with years of dialysis and organ quality. SD, standard deceased donor transplant; ECD, expanded criteria deceased donor transplant.

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    Figure 2.

    Projected life expectancy after ESRD onset by recipient age and treatment modality for patients with diabetes as the primary cause of ESRD. Life expectancies are calculated from the time of ESRD onset and incorporate the mortality rates associated with years of dialysis and organ quality.

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    Figure 3.

    Distribution of donor kidney type by pretransplant dialysis in older and younger patients.

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    Figure 4.

    Relative risk for not receiving a deceased donor kidney transplant once placed on the waiting list by candidate age. Reference group is 18- to 39-yr-olds; model additionally adjusted for candidate primary diagnosis, race, gender, previous transplant, and panel reactive antibody (PRA) level.

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    Figure 5.

    Relative risk for not receiving a deceased donor kidney transplant once placed on the waiting list by candidate age (censored for death). Reference group is 18- to 39-yr-olds; model additionally adjusted for candidate primary diagnosis, race, gender, previous transplant, and PRA level. Patients were included only when they were alive for the full applicable wait listing year.

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    Table 1

    Association of transplant candidate characteristics and odds of being placed on the expanded donor waiting lista

    Candidate CharacteristicOR95% CI
    Age
        18 to 39 (reference)
        40 to 541.401.34 to 1.46
        55 to 641.971.88 to 2.06
        65+2.992.80 to 3.18
    Gender
        male (reference)
        female0.920.89 to 0.95
    Race
        white (reference)
        black1.281.24 to 1.33
        other0.810.77 to 0.86
    Educational level
        college degree or higher (reference)
        less than college0.970.93 to 1.01
        attended college0.960.91 to 1.00
    Previous kidney transplant0.960.92 to 1.01
        no (reference)
        yes
    Peak PRA
        0 (reference)
        1 to 101.101.05 to 1.15
        11 to 301.181.11 to 1.26
        30+1.241.18 to 1.29
    Primary diagnosis
        GN (reference)
        diabetes1.341.28 to 1.41
        hypertension1.181.12 to 1.24
        polycystic disease1.081.01 to 1.16
        interstitial nephritis1.060.95 to 1.17
        other1.111.06 to 1.17
    • ↵a CI, confidence interval; GN, glomerulonephritis; OR, odds ratio; PRA, panel reactive antibodies.

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    Table 2

    Percentage of wait-listed patients who received deceased donor transplant by candidate age and time on waiting lista

    Time from Wait ListingbCandidate Age (%)
    18 to 3940 to 5455 to 6465+
    1 yr15.315.916.717.9
    2 yr10.110.29.99.1
    3 yr7.97.57.35.9
    4 yr6.05.65.23.4
    5 yr4.94.23.32.0
    6 yr2.82.31.80.8
    None (within 6 yr)49.249.650.957.7
    • ↵a Percentage of patients who received a transplant by year, conditioned on not receiving a transplant earlier in the waiting list period.

    • ↵b Calculated for transplants with applicable amount of follow-up time (e.g., 6 yr includes transplants from 1995 to 1998 with follow-up through 2004).

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Clinical Journal of the American Society of Nephrology
Vol. 1, Issue 3
May 2006
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Which Renal Transplant Candidates Should Accept Marginal Kidneys in Exchange for a Shorter Waiting Time on Dialysis?
Jesse D. Schold, Herwig-Ulf Meier-Kriesche
CJASN May 2006, 1 (3) 532-538; DOI: 10.2215/CJN.01130905

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Which Renal Transplant Candidates Should Accept Marginal Kidneys in Exchange for a Shorter Waiting Time on Dialysis?
Jesse D. Schold, Herwig-Ulf Meier-Kriesche
CJASN May 2006, 1 (3) 532-538; DOI: 10.2215/CJN.01130905
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More in this TOC Section

  • Proteins in Preservation Fluid as Predictors of Delayed Graft Function in Kidneys from Donors after Circulatory Death
  • Donor-Recipient Weight and Sex Mismatch and the Risk of Graft Loss in Renal Transplantation
  • A Case-Based Analysis of Whether Living Related Donors Listed for Transplant Share ESRD Causes with Their Recipients
Show more Renal Transplantation

Cited By...

  • A Donor Utilization Index to Assess the Utilization and Discard of Deceased Donor Kidneys Perceived as High Risk
  • Predicting kidney transplant outcomes with partial knowledge of HLA mismatch
  • Characteristics and Performance of Unilateral Kidney Transplants from Deceased Donors
  • Association of Kidney Transplantation with Survival in Patients with Long Dialysis Exposure
  • Stretching the Limits of Renal Transplantation in Elderly Recipients of Grafts from Elderly Deceased Donors
  • Mortality among Younger and Older Recipients of Kidney Transplants from Expanded Criteria Donors Compared with Standard Criteria Donors
  • A Lifetime of Allograft Function with Kidneys from Older Donors
  • Reassessing Medical Risk in Living Kidney Donors
  • Racial and Socioeconomic Disparities in the Allocation of Expanded Criteria Donor Kidneys
  • Differential Outcomes of Expanded-Criteria Donor Renal Allografts According to Recipient Age
  • Access to Kidney Transplantation among the Elderly in the United States: A Glass Half Full, not Half Empty
  • An Emerging Population: Kidney Transplant Candidates Who Are Placed on the Waiting List after Liver, Heart, and Lung Transplantation
  • Half of Kidney Transplant Candidates Who Are Older than 60 Years Now Placed on the Waiting List Will Die before Receiving a Deceased-Donor Transplant
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