Resultados a largo plazo en trasplante renal de donantes con criterios expandidos. EXPANDIDOS

Resumen

Background: Kidney transplantation of expanded criteria deceased donors (DCE) has become a common clinical practice. However, DCE outcomes are inferior compared to kidney transplants from standard criteria donors (DCS). Aim: To evaluate intermediate and long-term outcomes of DCE transplanted patients. Material and Methods: Cadaveric kidney transplants were evaluated using a retrospective cohort of eight consecutive years. Complications and long-term function of the transplant were assessed in DCE and DCS kidney recipients. Results: Of 213 patients analyzed, 34 (16%) underwent DCE transplantation. DCS recipients spent more time on the waiting list for transplantation (p=0.04). DCE recipients showed higher frequency of surgical complications (p=0.04), vascular complications (p=0.02), acute transplant rejection (p=0.05), and hospitalizations (p=0.01). Creatinine (mg/dL) in DCE and DCS recipients was 2.3 and 1.5 respectively at year one (p<0.01) and 2.6 and 1.6 respectively at year five (p<0.01). Graft survival in the DCE group was significantly lower at 5 years (61 and 89% respectively, p<0.01). Conclusions: DCE grafts are associated with lower survival, higher hospitalization rate and commonly develop surgical complications and rejections.