Abstract
Introduction. Expanding donation criteria is one way of solving the problem of the increasing need of transplantation. The article is dedicated to comparison of the outcomes of first and second repeated kidney transplantation using grafts from standard criteria and expanded criteria donors.Aim. To evaluate 1-year and 5-year recipient and kidney graft survival rates after first and second kidney transplantation according to the donor type – standard criteria or expanded criteria donors.Material and methods. From 2007 till 2019 we performed 1459 kidney transplantations. The comparison study of outcomes of first (n=196) and second (n=143) kidney transplantations from standard criteria (n=245) and expanded criteria (n=94) donors was made.Results. There were no significant differences in a 1-year patient survival according to the donor type (98% and 95%, p=0.13). A 5-year recipient survival was significantly poorer after kidney transplantation from expanded criteria donors (97.6% and 88%, p=0.01). There were no significant differences in 1-year and 5-year graft survival rates according to the order of transplantation (p=0.21 and p=0.36). We found no significant difference in 1-year recipient survival after kidney transplantation from expanded criteria donors according to the order of transplantation (p=0.50). A 5-year recipient survival was significantly difference poorer after second kidney transplantation from expanded criteria donors (p=0.04). One-year and 5-year graft survival rates were significantly lower after kidney transplantation from expanded criteria donors (94%, 88% vs 86%, 65%, p=0.0025 and p=0.0011, respectively). One-year and 5-year survival rates were higher after first kidney transplantation from standard criteria donors in comparison with second kidney transplantation (p=0.052 and p=0.02, statistically significant in both cases). Analyzing outcomes of kidney transplantation from expanded criteria donors we found 1-year and 5-year graft survivals to be higher after first kidney transplantation comparing with second kidney transplantation (p=0.030 and p=0.018, statistically significant in both cases).Conclusion. In case of second organ transplantation, it is reasonable to use organs from standard criteria donors.
Highlights
Expanding donation criteria is one way of solving the problem of the increasing need of transplantation
We found no significant difference in 1-year recipient survival after kidney transplantation from expanded criteria donors according to the order of transplantation (p=0.50)
One-year and 5-year graft survival rates were significantly lower after kidney transplantation from expanded criteria donors (94%, 88% vs 86%, 65%, p=0.0025 and p=0.0011, respectively)
Summary
Статистически значимых отличий в 1- и 5-летней выживаемости реципиентов почки от стандартных доноров в зависимости от очередности трансплантации выявлено не было (p=0,21 и p=0,36). Статистически значимых отличий в 1-летней выживаемости реципиентов почки от доноров с расширенными критериями в зависимости от очередности трансплантации выявлено не было (p=0,50). Показатели 1- и 5-летней выживаемости почечного аллотрансплантата были статистически значимо ниже при трансплантации органов от доноров с расширенными критериями (94%, 88% по сравнению с 86%, 65%, p=0,0025 и p=0,0011 соответственно). При трансплантации органов от стандартных доноров были отмечены более высокие показатели 1- и 5-летней выживаемости трансплантатов после первой трансплантации по сравнению с повторной (p=0,052 и p=0,02, статистически значимо в обоих случаях). При трансплантации почек от доноров с расширенными критериями были выявлены статистически значимо более высокие показатели 1- и 5-летней выживаемости трансплантатов почки после первой трансплантации по сравнению с повторной (p=0,030 и p=0,018, статистически значимо в обоих случаях). Ключевые слова: первая трансплантация почки, повторная (вторая) трансплантация почки, исходы, выживаемость реципиентов, выживаемость почечного трансплантата
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