Journal List > J Korean Soc Transplant > v.26(1) > 1034388

Lee, Huh, Lee, Kim, Kim, Joo, Kim, and Kim: Waiting Time for Deceased Donor Kidney Allocation in Korea: A Single Center Experience

Abstract

Background

The kidney recovery rate associated with deceased donors has increased after the establishment of the Korean Network for Organ Sharing (KONOS). And the KONOS organ allocation system gives priority to candidates affiliated with a Hospital based Organ Procurement Organization (HOPO) and/or donor recovery hospital. Regardless of whether or not this organ allocation system is fair, it can make an important impact on the waiting time for an organ transplant.

Methods

A total of 157 deceased donor kidney transplantations were performed at Severance Hospital between January 2006 and April 2011. The recipients of these transplantations were retrospectively divided into five groups according to their allocation types; general allocation group (GA, n=54), HOPO priority group (HP, n=65), zero antigen mismatching group (ZM, n=23), marginal donor allocation group (MD, n=7), and the combined organ transplant allocation group (CT, n=8). The five groups were assessed in terms of their waiting time for organ allocation, cold ischemia time, and post-transplant graft outcome.

Results

Mean waiting time for organ allocation of the HP group (69.5±27.4 months) was significantly shorter than for the GA group (90.0±34.0 months)(P<0.05). However, the degree of HLA mismatching was not different between each group. The cold ischemia time for the HP group (301.5±133.9 min) was significantly shorter than all other groups, except for the ZM group. There were no differences between groups in terms of acute rejection episodes, delayed graft function events or graft survival rates.

Conclusions

Our retrospective analysis of the kidney allocation pattern showed that there were disparities in distribution by priority of allocation. We should make a consensus within the Korean transplant society in order to further develop the allocation system to decease donor kidney transplantation time.

Figures and Tables

Fig. 1
Waiting time to organ allocation according to types of allocation. *means P<0.05 versus general allocation group.
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Fig. 2
Cold ischemic time according to types of allocation. *means P<0.05 versus general allocation group.
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Fig. 3
Graft survival rate according to types of allocation.
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Table 1
Pre-transplant clinical manifestations according to allocation method
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Abbreviation: HOPO, hospital based organ procurement organization.

*P-value measured by ANOVA or Chi-square test among 5 allocation method. **P-value measured by Student t-test or Chi-square test between general allocation and HOPO priority group.

Table 2
Post-transplant results according to allocation method
jkstn-26-32-i002

Abbreviation: HOPO, hospital based organ procurement organization.

*P-value measured by ANOVA or Chi-square test among 5 allocation method. **P-value measured by Student t-test or Chi-square test between general allocation and HOPO priority group.

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