Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: Kidney allocation in Brazil is mainly based on HLA compatibility. However, since 2002, patients who are no longer effectively dialyzed because hemodialysis (HD) and peritoneal dialyisis (PD) are no longer possible or work well, has been considered as urgent priority for kidney transplantation (KT). There are few published data on the outcomes of these patients after KT. Methods: We examined retrospective data of all patients submitted to KT under urgency priority allocation in a single Brazilian transplant center from Jan 2010 to Oct 2015. Results: From 859 KT performed, 71 were transplanted under urgent priority criteria. 11 were excluded due to incomplete data or early transfer for follow-up in another center. The 60 analyzed patients were predominantly female (60%), young (36±19 yo), mixed race (65%) and with unknown etiology of CKD (35%). For dialysis modalityes before KT, 76% performed HD, 17% PD, and 7% both modalities. Retransplant patients were 30%, the mean PRA was 30±36% (0-98%), HLA mismatches were 5±1, and 21% presented DSA. No pre-transplant desensitization strategy was done. The time since the onset of dialysis and registration on the KT waiting list (WL) was 57±54 months, and the time between WL and KT was 10±21 months. Donors were predominantly young (29±12yo) and standard criteria donors (98%). In the evaluated follow-up time (29±16 months), 10 patients lost their grafts (4 vascular thrombosis, 2 acute rejection, 1 immune IFTA, 1 nonimmune IFTA, 1 BKV nephropathy, 1 pyelonephritis) and 1 patient died (sepsis). Overall 1, 3, and 5-year graft survival were 87, 82 and 73%, respectively. Univariable analysis did not identify risk factors for graft loss. Conclusion: Contrasting to the overall cohort of KT in our center, patients transplanted under medical urgency criteria were high immunological risk females. A small percentage of patients performed PD prior to transplantation, reflecting local social difficulties. Despite sensitization, the time for KT after been on WL was relatively short, but the time gap from the onset of dialysis and WL registration was prohibitive, indicating the need for better local policies. There was a significant percentage of early losses due to thrombosis, probable as a consequence of patients' vascular conditions.
CITATION INFORMATION: Oliveira J, Sandes-Freitas T, Oliveira M, Mesquita L, Dantas G, Daher E, Esmeraldo R. Prioritization for Kidney Transplant Due to Medical Urgency: Clinical Characteristics and Outcomes After Transplantation. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Oliveira J, Sandes-Freitas T, Oliveira M, Mesquita L, Dantas G, Daher E, Esmeraldo R. Prioritization for Kidney Transplant Due to Medical Urgency: Clinical Characteristics and Outcomes After Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/prioritization-for-kidney-transplant-due-to-medical-urgency-clinical-characteristics-and-outcomes-after-transplantation/. Accessed October 13, 2019.
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