Abstract
BackgroundEnd-stage renal disease (ESRD) creates a great burden on the quality of life. Patients after kidney transplantation have been reported to have a greater quality of life and better outcomes health outcomes. Therefore, it is important to optimize the best method of following well-constructed criteria such as the expanded criteria donor (ECD) to reduce the chances of rejection rate and deaths post-transplantation particularly in elderly patients in conjunction with the kidney profile donor index (KDPI).MethodsThis is a retrospective descriptive study of all patients who received kidney transplantation from a deceased donor from the ECD as well as ECD with donation after cardiac death (DCD) at St. Joseph Health Care Hospital over a 24 month time period from January 2017 to January 2019. All adult recipients from standard criteria donor (SCD) and living donors were excluded from the study.ResultsThe study included 60 patients with 36 (60%) from the ECD and 24 (40%) were from the ECD/DCD group. The most common cause of ESRD among recipients was diabetes mellitus (DM) involving 23 (38.3%) of the patients. The creatinine outcome was the highest in the ECD/DCD group at one month (211 ± 71) and the lowest creatinine recorded was also in the ECD/DCD at 12 months (160 ± 78). Lastly, only four patients died in 12 months and only six recipients reported graft loss over 12 months.ConclusionDescriptive data of the included ECD/DCD showed increase trend in survivability of the recipients when used among the elderly, giving us more insight on the benefits of ECD/DCD transplantation.
Highlights
Kidney transplantation proves to be the best treatment of choice for most patients with end-stage renal disease (ESRD)
There is a large gap between the number of patients waiting for a transplant and the number receiving a transplant, which leads to a renewed interest in the use of expanded criteria donor (ECD) kidneys to increase the donor pool for the elderly recipients [4,5]
Allocation policies from the United Network for Organ Sharing (UNOS) require those who are on the transplantation waiting list to be given the choice to be included in the ECD kidneys and those who are included in that list are eligible to receive standard criteria donor kidney (SCD) kidneys as well [6]
Summary
End-stage renal disease (ESRD) creates a great burden on the quality of life. Patients after kidney transplantation have been reported to have a greater quality of life and better outcomes health outcomes. It is important to optimize the best method of following well-constructed criteria such as the expanded criteria donor (ECD) to reduce the chances of rejection rate and deaths post-transplantation in elderly patients in conjunction with the kidney profile donor index (KDPI)
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