Characteristics and Outcomes of Deceased Donor Kidneys Turned Down by A Single Center and Transplanted Elsewhere

Document Type

Conference Proceeding

Publication Date

1-1-2025

Publication Title

Am J Transplant

Abstract

Background: The number of kidney transplants performed in the US remains insufficient for the number of patients awaiting one. To meet these demands and hit nationally set growth targets, it is imperative for transplant centers to review their kidney utilization practice, especially for kidneys that were not accepted. This study analyzed accepted versus turned down kidneys for Henry Ford Hospital to better understand acceptance practices and to evaluate the need for modifying our acceptance criteria. Methods: Retrospective analysis of OPTN data on deceased donor kidneys offered by Gift of Life Michigan to Henry Ford Hospital (HFH) between 8/2/2022 and 7/19/2024. Only kidneys that were ultimately transplanted were included. Kidneys were classified as either “kidney transplanted by center (KTC)” if accepted and transplanted by HFH and “kidney transplanted elsewhere (KTE)” if turned down by HFH and transplanted elsewhere. Kidneys turned down for donor variables or organ quality were included in the analysis. Kidney characteristics and recipient outcomes were compared between the two groups. Outcomes of interest were rate of delayed graft function (DGF), recipient 6-month and 1-year serum creatinine (Se Cr), and 6-month and 1-year graft survival (GS). Results: 312 kidneys were included, with 65 in the KTC group and 247 in the KTE group. Selected analysis results are shown in Figure 1. KTE kidneys came from donors with significantly higher KDPI and terminal creatinine. Other donoror kidney characteristics did not differ significantly between the two groups. Recipients of KTC kidneys had a significantly longer length of hospital stay, but DGF rate, 6-month and 1-year recipient renal function did not differ significantly between the two groups. Rates of 6-month GS were similar, while 1-year GS rates were significantly higher in the KTC group. Conclusions: Despite differences in donor characteristics, renal outcomes did not differ significantly between kidneys we accepted versus those turned down. Findings of comparable outcomes with KTE kidneys can help reframe a center’s understanding of acceptable organ quality metrics and motivate centers to rethink and expand their acceptance criteria. [Formula presented] DISCLOSURES: Z.Y. Lu: None. A. Yoshida: None. A. Patel: None.

Volume

25

Issue

1

First Page

S33

Last Page

S34

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