3
|
Yuan Q, Haque O, Hong S, Ortiz A, Bethea ED, Sise ME, Markmann JF, Elias N. Influence of donor and recipient hepatitis B virus infection on long-term outcomes after kidney transplantation. Clin Transplant 2021; 35:e14466. [PMID: 34545965 DOI: 10.1111/ctr.14466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/23/2021] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The demand for transplantable kidneys continues to outstrip supply, and the risk of donor-derived infection limits utilization. The effect of donor or recipient HBV status, defined by surface antigen (HBsAg) positivity, on long-term survival outcomes of kidney transplant (KT) is unknown. METHODS We conducted a retrospective cohort study based on Organ Procurement and Transplantation Network (OPTN) data from 2000 to 2019. We identified three cohorts based on donor (D) or recipient (R) HBsAg status: D-R, D-R+, and D+R-. Pairwise comparisons of patient survival (PS) and all-cause graft survival (GS) after propensity score matching were performed to assess the effect of HBV infection in KT recipients. RESULTS Our findings showed that there were no statistically significant differences in PS and GS among D-R, D-R+, and D+R-groups, nor was the patient or GS different between donor and recipient HBsAg+ status. Finally, in 2019 kidney discard rates were 15% higher for HBsAg+ deceased donors compared to HBsAg- donors. CONCLUSIONS HBsAg+ status was not associated with worse PS or GS after KT. Prior to broadly advocating utilization of HbsAg+ kidneys, further studies assessing KT recipient morbidity and safety are necessary.
Collapse
Affiliation(s)
- Qing Yuan
- Department of Urology, Chinese PLA General Hospital, Beijing, China.,Center for Transplantation Sciences, and Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Omar Haque
- Center for Transplantation Sciences, and Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Shriners Hospitals for Children, Boston, Massachusetts, USA
| | - Shanjuan Hong
- Center for Transplantation Sciences, and Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Andric Ortiz
- Center for Transplantation Sciences, and Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Emily D Bethea
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Division of Gastroenterology and Hepatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Meghan E Sise
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - James F Markmann
- Center for Transplantation Sciences, and Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Nahel Elias
- Center for Transplantation Sciences, and Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
10
|
Tanriover B, Mohan S, Cohen DJ, Radhakrishnan J, Nickolas TL, Stone PW, Tsapepas DS, Crew RJ, Dube GK, Sandoval PR, Samstein B, Dogan E, Gaston RS, Tanriover JN, Ratner LE, Hardy MA, Chvojka J, da Motta H, Devan J, Dytman SA, Díaz GA, Eberly B, Felix J, Fields L, Fiorentini GA, Gago AM, Gallagher H, Gran R, Harris DA, Higuera A, Hurtado K, Jerkins M, Kafka T, Kordosky M, Kulagin SA, Le T, Maggi G, Maher E, Manly S, Mann WA, Marshall CM, Martin Mari C, McFarland KS, McGivern CL, McGowan AM, Miller J, Mislivec A, Morfín JG, Muhlbeier T, Naples D, Nelson JK, Norrick A, Osta J, Palomino JL, Paolone V, Park J, Patrick CE, Perdue GN, Rakotondravohitra L, Ransome RD, Ray H, Ren L, Rodrigues PA, Savage DG, Schellman H, Schmitz DW, Simon C, Snider FD, Solano Salinas CJ, Tagg N, Valencia E, Velásquez JP, Walton T, Wolcott J, Zavala G, Zhang D, Ziemer BP. Kidneys at higher risk of discard: expanding the role of dual kidney transplantation. Am J Transplant 2014; 14:404-15. [PMID: 24472195 PMCID: PMC4058786 DOI: 10.1111/ajt.12553] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 10/15/2013] [Accepted: 10/15/2013] [Indexed: 01/25/2023]
Abstract
Half of the recovered expanded criteria donor (ECD) kidneys are discarded in the United States. A new kidney allocation system offers kidneys at higher risk of discard, Kidney Donor Profile Index (KDPI)>85%, to a wider geographic area to promote broader sharing and expedite utilization. Dual kidney transplantation (DKT) based on the KDPI is a potential option to streamline allocation of kidneys which otherwise would have been discarded. To assess the clinical utility of the KDPI in kidneys at higher risk of discard, we analyzed the OPTN/UNOS Registry that included the deceased donor kidneys recovered between 2002 and 2012. The primary outcomes were allograft survival, patient survival and discard rate based on different KDPI categories (<80%, 80-90% and >90%). Kidneys with KDPI>90% were associated with increased odds of discard (OR=1.99, 95% CI 1.74-2.29) compared to ones with KDPI<80%. DKTs of KDPI>90% were associated with lower overall allograft failure (HR=0.74, 95% CI 0.62-0.89) and better patient survival (HR=0.79, 95% CI 0.64-0.98) compared to single ECD kidneys with KDPI>90%. Kidneys at higher risk of discard may be offered in the up-front allocation system as a DKT. Further modeling and simulation studies are required to determine a reasonable KDPI cutoff percentile.
Collapse
Affiliation(s)
- B. Tanriover
- Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, NY,The Columbia University Renal Epidemiology (CURE) Group, Department of Medicine, Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, NY,Corresponding author: Bekir Tanriover,
| | - S. Mohan
- Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, NY,The Columbia University Renal Epidemiology (CURE) Group, Department of Medicine, Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, NY
| | - D. J. Cohen
- Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, NY
| | - J. Radhakrishnan
- Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, NY
| | - T. L. Nickolas
- Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, NY,The Columbia University Renal Epidemiology (CURE) Group, Department of Medicine, Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, NY
| | - P. W. Stone
- Center for Health Policy, Columbia University School of Nursing, New York, NY
| | - D. S. Tsapepas
- Department of Pharmacy, New York Presbyterian Hospital, New York, NY
| | - R. J. Crew
- Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, NY
| | - G. K. Dube
- Division of Nephrology, Columbia University College of Physicians and Surgeons, New York, NY
| | - P. R. Sandoval
- Renal and Pancreatic Transplantation, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY
| | - B. Samstein
- Renal and Pancreatic Transplantation, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY
| | - E. Dogan
- Division of Nephrology, Sutcu Imam University, Kahramanmaras, Turkey
| | - R. S. Gaston
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL
| | | | - L. E. Ratner
- Renal and Pancreatic Transplantation, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY
| | - M. A. Hardy
- Renal and Pancreatic Transplantation, Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY
| | - J Chvojka
- University of Rochester, Rochester, New York 14610, USA
| | - H da Motta
- Centro Brasileiro de Pesquisas Físicas, Rua Dr. Xavier Sigaud 150, Urca, Rio de Janeiro, Rio de Janeiro 22290-180, Brazil
| | - J Devan
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - S A Dytman
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - G A Díaz
- Sección Física, Departamento de Ciencias, Pontificia Universidad Católica del Perú, Apartado 1761, Lima, Peru
| | - B Eberly
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - J Felix
- Northwestern University, Evanston, Illinois 60208, USA
| | - L Fields
- Northwestern University, Evanston, Illinois 60208, USA
| | - G A Fiorentini
- Centro Brasileiro de Pesquisas Físicas, Rua Dr. Xavier Sigaud 150, Urca, Rio de Janeiro, Rio de Janeiro 22290-180, Brazil
| | - A M Gago
- Sección Física, Departamento de Ciencias, Pontificia Universidad Católica del Perú, Apartado 1761, Lima, Peru
| | - H Gallagher
- Physics Department, Tufts University, Medford, Massachusetts 02155, USA
| | - R Gran
- Department of Physics, University of Minnesota-Duluth, Duluth, Minnesota 55812, USA
| | - D A Harris
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Higuera
- Campus León y Campus Guanajuato, Universidad de Guanajuato, Lascurain de Retana No. 5, Col. Centro. Guanajuato 36000, Guanajuato, Mexico
| | - K Hurtado
- Centro Brasileiro de Pesquisas Físicas, Rua Dr. Xavier Sigaud 150, Urca, Rio de Janeiro, Rio de Janeiro 22290-180, Brazil and Universidad Nacional de Ingeniería, Apartado 31139 Lima, Peru
| | - M Jerkins
- Department of Physics, University of Texas, 1 University Station, Austin, Texas 78712, USA
| | - T Kafka
- Physics Department, Tufts University, Medford, Massachusetts 02155, USA
| | - M Kordosky
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - S A Kulagin
- Institute for Nuclear Research of the Russian Academy of Sciences, 117312 Moscow, Russia
| | - T Le
- Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, USA
| | - G Maggi
- Departamento de Física, Universidad Técnica Federico Santa María, Avenida España 1680 Casilla 110-V, Valparaíso, Chile
| | - E Maher
- Massachusetts College of Liberal Arts, 375 Church Street, North Adams, Massachusetts 01247, USA
| | - S Manly
- University of Rochester, Rochester, New York 14610, USA
| | - W A Mann
- Physics Department, Tufts University, Medford, Massachusetts 02155, USA
| | - C M Marshall
- University of Rochester, Rochester, New York 14610, USA
| | | | - K S McFarland
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA and University of Rochester, Rochester, New York 14610, USA
| | - C L McGivern
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - A M McGowan
- University of Rochester, Rochester, New York 14610, USA
| | - J Miller
- Departamento de Física, Universidad Técnica Federico Santa María, Avenida España 1680 Casilla 110-V, Valparaíso, Chile
| | - A Mislivec
- University of Rochester, Rochester, New York 14610, USA
| | - J G Morfín
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Muhlbeier
- Centro Brasileiro de Pesquisas Físicas, Rua Dr. Xavier Sigaud 150, Urca, Rio de Janeiro, Rio de Janeiro 22290-180, Brazil
| | - D Naples
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - J K Nelson
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - A Norrick
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - J Osta
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J L Palomino
- Centro Brasileiro de Pesquisas Físicas, Rua Dr. Xavier Sigaud 150, Urca, Rio de Janeiro, Rio de Janeiro 22290-180, Brazil
| | - V Paolone
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - J Park
- University of Rochester, Rochester, New York 14610, USA
| | - C E Patrick
- Northwestern University, Evanston, Illinois 60208, USA
| | - G N Perdue
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA and University of Rochester, Rochester, New York 14610, USA
| | | | - R D Ransome
- Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, USA
| | - H Ray
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - L Ren
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
| | - P A Rodrigues
- University of Rochester, Rochester, New York 14610, USA
| | - D G Savage
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - H Schellman
- Northwestern University, Evanston, Illinois 60208, USA
| | - D W Schmitz
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - C Simon
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - F D Snider
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | | | - N Tagg
- Department of Physics, Otterbein University, 1 South Grove Street, Westerville, Ohio 43081, USA
| | - E Valencia
- Campus León y Campus Guanajuato, Universidad de Guanajuato, Lascurain de Retana No. 5, Col. Centro. Guanajuato 36000, Guanajuato, Mexico
| | - J P Velásquez
- Sección Física, Departamento de Ciencias, Pontificia Universidad Católica del Perú, Apartado 1761, Lima, Peru
| | - T Walton
- Department of Physics, Hampton University, Hampton, Virginia 23668, USA
| | - J Wolcott
- University of Rochester, Rochester, New York 14610, USA
| | - G Zavala
- Campus León y Campus Guanajuato, Universidad de Guanajuato, Lascurain de Retana No. 5, Col. Centro. Guanajuato 36000, Guanajuato, Mexico
| | - D Zhang
- Department of Physics, College of William & Mary, Williamsburg, Virginia 23187, USA
| | - B P Ziemer
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | | |
Collapse
|
11
|
Park UJ, Cho WH, Kim HT, Kim MY, Kim YL, Kim CD, Cho JH, Kim YH, Park SJ, Chung SY, Choi SJN, Lee HK, Park SK, Lee S, Yu HC. Evaluation of the Korean Network for Organ Sharing Expanded Donor Criteria in Deceased Donor Renal Transplantation. KOREAN JOURNAL OF TRANSPLANTATION 2013. [DOI: 10.4285/jkstn.2013.27.4.166] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ui Jun Park
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Won Hyun Cho
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Hyoung Tae Kim
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Min Young Kim
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Yong-Lim Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Chan-Duck Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jang-Hee Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Young Hoon Kim
- Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Suk Joo Park
- Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang Young Chung
- Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Jin Na Choi
- Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Ho Kyun Lee
- Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Sung Kwang Park
- Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Sik Lee
- Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Hee Chul Yu
- Department of Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| |
Collapse
|