A5023281204- Organ Transplantation Techniques and Outcomes
- Renal Transplantation Outcomes and Treatments
- Organ Donation and Transplantation
- Liver Disease and Transplantation
- Renal and Vascular Pathologies
- Liver Disease Diagnosis and Treatment
- Health and Medical Studies
- Social and Demographic Issues in Germany
- Neurological Complications and Syndromes
- Medical and Health Sciences Research
- Acute Kidney Injury Research
- Pregnancy and Medication Impact
- Medical Practices and Rehabilitation
- Transplantation: Methods and Outcomes
- Cytomegalovirus and herpesvirus research
- Clinical practice guidelines implementation
Eurotransplant
2009-2024
Medical University of Vienna
2023
Fundación Juan March
2023
Leiden University Medical Center
2009
Recent studies raised the concern that warm ischemia during completion of vascular anastomoses in kidney implantation harms transplant, but its precise impact on outcome and interaction with other risk factors remain to be established. We investigated relationship between anastomosis time graft survival at 5 years after transplantation 13 964 recipients deceased donor solitary transplants Eurotransplant region. Anastomosis was independently associated loss adjusting for (adjusted hazard...
Circulatory death donor (DCD) kidney transplantations are steadily increasing. Consensus reports recommend limiting warm ischemia time (DWIT) in DCD donation, although an independent effect on graft outcome has not been demonstrated. We investigated death-censored survival 18 065 recipients of deceased-donor transplants the Eurotransplant region: 1059 and 17 006 brain-dead (DBD) recipients. DWIT was defined as from circulatory arrest until cold flush. donation risk factor for failure...
Assessing the effect of donor hepatectomy time on outcome after transplantation.When blood supply in a deceased organ stops, ischemic injury starts. Livers are cooled to reduce cellular metabolism and minimize injury. This cooling is slow livers lukewarm during hepatectomy, potentially affecting outcome.We used Eurotransplant Registry investigate relationship between post-transplant 12,974 recipients deceased-donor (January 1, 2004, December 31, 2013). Cox regression analyses for patient...
The liver graft quickly rewarms during transplantation when the vascular anastomoses are being performed, potentially impacting on outcomes.We investigated relationship between implantation time and outcome in 5223 recipients of deceased-donor livers transplanted Eurotransplant (2004-2013). Cox regression analyses were corrected for donor, preservation, recipient variables. Transplant loss represents all-cause failure.Median was 41 minutes (interquartile range, 34-51). Implantation...
The Eurotransplant Senior Program (ESP) has expedited the chance for elderly patients with kidney failure to receive a timely transplant. This current study evaluated survival parameters of kidneys donated after brain death or without matching HLA-DR antigens. cohort period within ESP paired allocation 675 from donors 65 years and older transplant candidates older, first 341 DR-compatible 334 contralateral antigen matching. We used Kaplan-Meier estimates competing risk analysis assess all...
Abstract Background Changes in recipient and donor factors have reopened the question of survival benefits kidney transplantation versus dialysis. Methods We analysed among 3808 adult Belgian patients waitlisted for a first deceased transplant from 2000 to 2012. The primary outcome was mortality during median waiting time plus 3 years follow-up after or with continued Outcomes were separately standard criteria (SCD) expanded (ECD) transplants. adjusted analyses age (20–44, 45–64 ≥65 years),...
In order to achieve short ischemia times between organ donation and transplantation, regional allocation has been assigned priority in the development of rules for kidney transplantation. It is unclear whether this leads differences waiting Germany.A retrospective cohort study over a 24-month observation period was conducted, including all patients who received kidney-only graft allocated via standard Eurotransplant Kidney Allocation System (ETKAS) (n = 1487) or Senior Program (ESP) 566)....
All organ exchange organizations are challenged to maximize the utilization rate of all donors.To investigate benefit a rescue allocation policy and study impact donor factors on risk kidney discard.All 4057 donors with kidneys offered for Eurotransplant between 2006 2007 were included. Allocation was patient-oriented, based point-score system including recipient factors. If an offer rejected 5 times medical reasons, switched (ie, then in center-oriented way). A logistic regression model...
Abstract Background When the blood supply ceases in a deceased organ donor, ischaemic injury starts. Kidneys are cooled to reduce cellular metabolism and minimize injury. This cooling is slow kidneys lukewarm during nephrectomy. Smaller single-centre studies have shown that prolonged donor nephrectomy time decreases early kidney transplant function, but effect on long-term outcome has never been investigated large multicentre cohort studies. Methods The relationship between death-censored...
Assignment of unacceptable HLA mismatches (UAMs) prevents transplantation incompatible grafts but potentially prolongs waiting time. Whether this is true in the Eurotransplant Kidney Allocation System (ETKAS) and Senior Program Germany highly debated relevant for UAM policies.Donor pool restriction due to was expressed as percent virtual panel-reactive antibodies (vPRAs). Kaplan-Meier estimates multivariable Cox regression models were used analyze impact vPRA levels on time transplant...
The presence of donor-specific HLA antibodies before transplantation is associated with poor outcomes. Unacceptable antigens can be assigned for Eurotransplant kidney transplant candidates to prevent offers against which the candidate has developed clinically relevant antibodies. This retrospective cohort study aimed assess what degree unacceptable affect access in Kidney Allocation System (ETKAS).Candidates who underwent kidney-only between 2016 and 2020 were included (n = 19 240). Cox...
At Eurotransplant (ET), kidneys are transferred to "rescue allocation" (RA), whenever the standard allocation (SA) algorithms Kidney Allocation System (ETKAS) and Senior Program (ESP) fail. We analyzed outcome of RA.Retrospective patient clinical demographic characteristics association analyses were performed with graft outcomes for 2422 recipients a deceased donor renal transplantation (DDRT) after RA versus 25 481 SA from 71 centers across all ET countries 2006 2018.Numbers DDRTs increased...
Background Little is known about the time-varying determinants of kidney graft failure in children. Methods We performed a retrospective study primary pediatric transplant recipients (younger than 18 years) from Eurotransplant registry (1990–2020). Piece-wise exponential additive mixed models were applied to analyze recipient, donor, and risk factors. Primary outcome was death-censored failure. Results report on 4528 transplantations, which 68% with deceased 32% living donor. One thousand...
Background. Whenever the kidney standard allocation (SA) algorithms according to Eurotransplant (ET) Kidney Allocation System or Senior Program fail, rescue (RA) is initiated. There are 2 procedurally different modes of RA: recipient oriented extended (REAL) and competitive (CRA). The objective this study was evaluate association patient survival graft failure with RA mode whether not it varied across ET countries. Methods. database retrospectively analyzed for donor clinical demographic...
ABSTRACT Background The decision to accept or discard the increasingly rare and marginal brain-dead donor kidneys in Eurotransplant (ET) countries has be made without solid evidence. Thus, we developed validated flexible clinicopathological scores called 2-Step Scores for prognosis of delayed graft function (DGF) 1-year death-censored transplant loss (1y-tl) reflecting current practice six ET including Croatia Belgium. Methods training set was n = 620 DGF 711 1y-tl, with validation sets 158...
Kidneys from infants with anuric acute kidney injury (AKI) only rarely get accepted for transplantation despite encouraging data that such kidneys can have very good long-term outcome.We report the of four grafts two pediatric donors (3 and 4 years) as single into adult recipients.All gained function within 14 days posttransplantation, one recipient needed dialysis after transplantation. None recipients suffered surgical complications. One month transplantation, all were free dialysis....
Rahmel, A; Smits, J; de Vries, E; Slot, M; Boer, Tieken, I; Frei, U; Fijter, H Author Information
old and acute kidney disease.At the last stage, we select 79 patients who strated on dialysis but had an early FCN.This method estimate a potential of 228 PTX in pediatrics France between 2010 2016.Worth mentioning, despite our approach, living donor rate still differ starting (11%) PTx (40%), (p<0.001).CONCLUSIONS: This study demonstrates that significant part pediatric as first RRT modality would have been suitable candidates for PTx.An earlier management with chronic disease may result...
Abstract Background and Aims Older studies have shown a survival benefit with kidney transplantation compared to dialysis, even for patients older than 60 years. However, due important evolutions such as recipient age the use of less-than-optimal quality donors, it is unclear if still holds true nowadays. Method Patient was analyzed 3808 Belgian waitlisted first deceased donor transplant between 2000 2012. Patients were divided into categories (20-44y, 45-64y, ≥65y). Primary outcome...