Assfalg, Volker, Hueser, Norbert, van Meel, Marieke, Haller, Bernhard ORCID: 0000-0002-9723-393X, Rahmel, Axel, de Boer, Jan, Matevossian, Edouard, Novotny, Alexander, Knops, Noel ORCID: 0000-0001-5743-0966, Weekers, Laurent, Friess, Helmut, Pratschke, Johann, Fuegger, Reinhold, Janko, Otmar, Rasoul-Rockenschaub, Susanne, Bosmans, Jean-Louis ORCID: 0000-0001-7928-5675, Broeders, Nilufer, Peeters, Patrick, Mourad, Michel, Kuypers, Dirk, Slavicek, Jasna, Muehlfeld, Anja, Sommer, Florian, Viebahn, Richard ORCID: 0000-0002-2051-0898, Pascher, Andreas, van der Giet, Markus ORCID: 0000-0003-3590-5451, Zantvoort, Frans, Woitas, Rainer P., Putz, Juliane, Grabitz, Klaus, Kribben, Andreas, Hauser, Ingeborg, Pisarski, Przemyslaw, Weimer, Rolf, Lorf, Thomas, Fornara, Paola, Morath, Christian, Nashan, Bjoern, Lehner, Frank, Kliem, Volker, Sester, Urban ORCID: 0000-0003-4007-5595, Grimm, Marc-Oliver ORCID: 0000-0003-3084-8654, Feldkamp, Thorsten, Kleinert, Robert, Arns, Wolfgang, Moench, Christian, Schoenberg, Markus Bo ORCID: 0000-0002-5806-8249, Nitschke, Martin, Krueger, Bernd, Thorban, Stefan, Arbogast, Helmut P., Wolters, Heiner H., Maier, Tanja, Lutz, Jens, Heller, Katharina, Banas, Bernhard, Hakenberg, Oliver, Kalus, Martin, Nadalin, Silvio, Keller, Frieder, Lopau, Kai, Bemelman, Frederike Jose, Nurmohamed, Shaikh, Sanders, Jan-Stephan, de Fijter, Johan W., Christiaans, Maarten, Hilbrands, Luuk ORCID: 0000-0002-4935-9765, Betjes, Michiel ORCID: 0000-0001-9435-6208, van Zuilen, Arjan and Heemann, Uwe (2016). High-urgency kidney transplantation in the Eurotransplant Kidney Allocation System: success or waste of organs? The Eurotransplant 15-year all-centre survey. Nephrol. Dial. Transplant., 31 (9). S. 1515 - 1523. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2385

Full text not available from this repository.

Abstract

In the Eurotransplant Kidney Allocation System (ETKAS), transplant candidates can be considered for high-urgency (HU) status in case of life-threatening inability to undergo renal replacement therapy. Data on the outcomes of HU transplantation are sparse and the benefit is controversial. We systematically analysed data from 898 ET HU kidney transplant recipients from 61 transplant centres between 1996 and 2010 and investigated the 5-year patient and graft outcomes and differences between relevant subgroups. Kidney recipients with an HU status were younger (median 43 versus 55 years) and spent less time on the waiting list compared with non-HU recipients (34 versus 54 months). They received grafts with significantly more mismatches (mean 3.79 versus 2.42; P < 0.001) and the percentage of retransplantations was remarkably higher (37.5 versus 16.7%). Patient survival (P = 0.0053) and death with a functioning graft (DwFG; P < 0.0001) after HU transplantation were significantly worse than in non-HU recipients, whereas graft outcome was comparable (P = 0.094). Analysis according to the different HU indications revealed that recipients listed HU because of an imminent lack of access for dialysis had a significantly worse patient survival (P = 0.0053) and DwFG (P = 0.0462) compared with recipients with psychological problems and suicidality because of dialysis. In addition, retransplantation had a negative impact on patient and graft outcome. Facing organ shortages, increasing wait times and considerable mortality on dialysis, we question the current policy of HU allocation and propose more restrictive criteria with regard to individuals with vascular complications or repeated retransplantations in order to support patients on the non-HU waiting list with a much better long-term prognosis.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Assfalg, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hueser, NorbertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Meel, MariekeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haller, BernhardUNSPECIFIEDorcid.org/0000-0002-9723-393XUNSPECIFIED
Rahmel, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Boer, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Matevossian, EdouardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Novotny, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Knops, NoelUNSPECIFIEDorcid.org/0000-0001-5743-0966UNSPECIFIED
Weekers, LaurentUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Friess, HelmutUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pratschke, JohannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fuegger, ReinholdUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Janko, OtmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rasoul-Rockenschaub, SusanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bosmans, Jean-LouisUNSPECIFIEDorcid.org/0000-0001-7928-5675UNSPECIFIED
Broeders, NiluferUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Peeters, PatrickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mourad, MichelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuypers, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Slavicek, JasnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muehlfeld, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sommer, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Viebahn, RichardUNSPECIFIEDorcid.org/0000-0002-2051-0898UNSPECIFIED
Pascher, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der Giet, MarkusUNSPECIFIEDorcid.org/0000-0003-3590-5451UNSPECIFIED
Zantvoort, FransUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Woitas, Rainer P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Putz, JulianeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grabitz, KlausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kribben, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hauser, IngeborgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pisarski, PrzemyslawUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weimer, RolfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lorf, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fornara, PaolaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morath, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nashan, BjoernUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lehner, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kliem, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sester, UrbanUNSPECIFIEDorcid.org/0000-0003-4007-5595UNSPECIFIED
Grimm, Marc-OliverUNSPECIFIEDorcid.org/0000-0003-3084-8654UNSPECIFIED
Feldkamp, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kleinert, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arns, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moench, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schoenberg, Markus BoUNSPECIFIEDorcid.org/0000-0002-5806-8249UNSPECIFIED
Nitschke, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krueger, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thorban, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arbogast, Helmut P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wolters, Heiner H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maier, TanjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lutz, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heller, KatharinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Banas, BernhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hakenberg, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kalus, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nadalin, SilvioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Keller, FriederUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lopau, KaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bemelman, Frederike JoseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nurmohamed, ShaikhUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sanders, Jan-StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Fijter, Johan W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Christiaans, MaartenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hilbrands, LuukUNSPECIFIEDorcid.org/0000-0002-4935-9765UNSPECIFIED
Betjes, MichielUNSPECIFIEDorcid.org/0000-0001-9435-6208UNSPECIFIED
van Zuilen, ArjanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heemann, UweUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-263676
DOI: 10.1093/ndt/gfv446
Journal or Publication Title: Nephrol. Dial. Transplant.
Volume: 31
Number: 9
Page Range: S. 1515 - 1523
Date: 2016
Publisher: OXFORD UNIV PRESS
Place of Publication: OXFORD
ISSN: 1460-2385
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
WAITING TIME; SURVIVAL BENEFIT; DIALYSIS; CANDIDATES; PRIORITYMultiple languages
Transplantation; Urology & NephrologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/26367

Downloads

Downloads per month over past year

Altmetric

Export

Actions (login required)

View Item View Item