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Patient and kidney graft survival rates after first and second kidney transplantation

https://doi.org/10.23873/2074-0506-2021-13-2-130-140

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.

About the Authors

M. Sh. Khubutiya
N.V. Sklifosovsky Research Institute for Emergency Medicine; A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation

Mogeli Sh. Khubutiya, Academician of the Russian Academy of Sciences, Prof., Dr. Sci. (Med.), President of N.V. Sklifosovsky Research Institute for Emergency Medicine; Head of the Department of Transplantology and Artificial Organs, A.I. Yevdokimov Moscow State University of Medicine and Dentistry

3 Bolshaya Sukharevskaya Sq., Moscow 129090
1 Bldg. 20 Delegatskaya St., Moscow 127473



A. V. Pinchuk
N.V. Sklifosovsky Research Institute for Emergency Medicine; A.I. Yevdokimov Moscow State University of Medicine and Dentistry; Research Institute for Healthcare Organization and Medical Management
Russian Federation

Aleksey V. Pinchuk, Dr. Sci. (Med.), Head of the Scientific Department of Kidney and Pancreas Transplantation, N.V. Sklifosovsky Research Institute for Emergency Medicine; Associate Professor of the Department of Transplantology and Artificial Organs, A.I. Yevdokimov Moscow State University of Medicine and Dentistry; Head of the Organizational and Methodological Department for Transplantology, Research Institute for Healthcare Organization and Medical Management

3 Bolshaya Sukharevskaya Sq., Moscow 129090
1 Bldg. 20 Delegatskaya St., Moscow 127473
30 Bolshaya Tatarskaya St., Moscow 115184



N. V. Shmarina
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation

Nonna V. Shmarina, Cand. Sci. (Med.), Senior Researcher, Department of Kidney and Pancreas Transplantation

3 Bolshaya Sukharevskaya Sq., Moscow 129090



I. V. Dmitriev
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation

Ilya V. Dmitriev, Cand. Sci. (Med.), Head of the Clinical Department of Kidney and Pancreas Transplantation

3 Bolshaya Sukharevskaya Sq., Moscow 129090



V. E. Vinogradov
Research Institute for Healthcare Organization and Medical Management; Moscow City Scientific and Practical Center of Nephrology and Transplanted Kidney Pathology, Moscow City Clinical Hospital № 52
Russian Federation

Vladimir E. Vinogradov, Specialist of the Organizational and Methodological Department in Nephrology, Research Institute for Healthcare Organization and Medical Management; Head of the Consultative Diagnostic Nephrological Department, Moscow City Scientific and Practical Center of Nephrology and Transplanted Kidney Pathology, Moscow City Clinical Hospital № 52

30 Bolshaya Tatarskaya St., Moscow 115184
3 Pekhotnaya St., Moscow 123182



A. I. Kazantsev
N.V. Sklifosovsky Research Institute for Emergency Medicine
Russian Federation

Andrey I. Kazantsev, Surgeon of the Department of Kidney and Pancreas Transplantation

3 Bolshaya Sukharevskaya Sq., Moscow 129090



A. G. Balkarov
N.V. Sklifosovsky Research Institute for Emergency Medicine; Research Institute for Healthcare Organization and Medical Management
Russian Federation

Aslan G. Balkarov, Cand. Sci. (Med.), Surgeon, Department of Kidney and Pancreas Transplantation, N.V. Sklifosovsky Research Institute for Emergency Medicine, Leading Specialist of the Organizational and Methodological Department for Transplantology, Research Institute for Healthcare Organization and Medical Management

3 Bolshaya Sukharevskaya Sq., Moscow 129090
30 Bolshaya Tatarskaya St., Moscow 115184



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Review

For citations:


Khubutiya M.Sh., Pinchuk A.V., Shmarina N.V., Dmitriev I.V., Vinogradov V.E., Kazantsev A.I., Balkarov A.G. Patient and kidney graft survival rates after first and second kidney transplantation. Transplantologiya. The Russian Journal of Transplantation. 2021;13(2):130-140. https://doi.org/10.23873/2074-0506-2021-13-2-130-140

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ISSN 2074-0506 (Print)
ISSN 2542-0909 (Online)