A Preliminary Study to Revise the Marginal Donor Criteria of KONOS in Deceased Donor Kidney Transplantation

Wooseong Huh

doi:10.4285/jkstn.2017.31.2.59

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Huh: A Preliminary Study to Revise the Marginal Donor Criteria of KONOS in Deceased Donor Kidney Transplantation

Review Article

The Journal of the Korean Society for Transplantation 2017; 31(2): 59-67.

Published online: 30 June 2017

DOI: https://doi.org/10.4285/jkstn.2017.31.2.59

A Preliminary Study to Revise the Marginal Donor Criteria of KONOS in Deceased Donor Kidney Transplantation

Wooseong Huh, M.D.

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Corresponding author: Wooseong Huh. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel: 82-2-3410-3443, Fax: 82-2-3410-0064, wooseong.huh@samsung.com

Received 29 May 2017 Revised 16 June 2017 Accepted 16 June 2017

Abstract

Background

The Korean Network for Organ Sharing (KONOS), which was established in December 31st, 1999, is a nationwide system of deceased donor detection and distribution. From its inception, KONOS has defined marginal donors and used this definition for over 15 years. However, this definition should be reevaluated to determine if it requires revision. This study was conducted to confirm the feasibility of the main study for revision of the marginal donor definition in deceased donor kidney transplantation.

Methods

This study is a retrospective meta-analysis of 786 patients who had deceased donor kidney transplant from six centers. After the data validation process, multivariable analysis was conducted to evaluate whether the marginal donor criteria of KONOS or UNOS expected adequately in terms of graft survival and delayed graft function (DGF).

Results

Neither the KONOS or UNOS criteria affected graft survival. Expanded criteria for donors of UNOS was a risk factor for DGF. However, KONOS criteria did not affect DGF.

Conclusions

Based on this preliminary study, there is a need to conduct a study to revise the marginal donor criteria of KONOS in deceased donor kidney transplantation. Such a study should have large scale and long-term follow-up data.

Keywords: Organ donor, Brain death, Kidney transplantation

Figures and Tables

Table 1

Baseline characteristics according to donor status classified by KONOS criteria

Data are presented as mean±SD or number (%).

Abbreviations: KONOS, Korean Network for Organ Sharing; CVA, cardiovascular accident.

Table 2

Baseline characteristics according to donor status classified by UNOS criteria

Data are presented as mean±SD or number (%).

Abbreviations: UNOS, United Network for Organ Sharing; CVA, cardiovascular accident.

Table 3

Baseline characteristics according to donor status classified by KONOS-UNOS criteria

Data are presented as mean±SD or number (%).

Abbreviations: SD, standard donor defined by KONOS criteria; MD, marginal donor defined by KONOS criteria; SCD, standard criteria donor defined by UNOS criteria; ECD, expanded criteria donor defined by UNOS criteria; CVA, cardiovascular accident.

Table 4

Multivariable analysis of risk factors for graft failure

Abbreviations: HR, hazard ration; CI, confidence interval; SD, standard donor defined by KONOS criteria; MD, marginal donor defined by KONOS criteria; SCD, standard criteria donor defined by UNOS criteria; ECD, expanded criteria donor defined by UNOS criteria; KONOS, Korean Network for Organ Sharing; UNOS, United Network for Organ Sharing.

Table 5

Multivariable analysis of risk factors for delayed graft function

References

1. Korean Network for Organ Sharing (KONOS). 2015 Annual data report [Internet]. Seoul: KONOS;2016. cited 2016 Oct 21. Available from: http://konos.go.kr.

2. Global Observatory on Donation and Transplantation (GODT). Total rate (pmp) total number of actual deceased organ donor (Global. 2014) [Internet]. GODT;2016. cited 2016 Oct 20. Available from: http://transplant-observatory.org.

3. Matesanz R, Dominguez-Gil B, Coll E, de la Rosa G, Marazuela R. Spanish experience as a leading country: what kind of measures were taken? Transpl Int. 2011; 24:333–343.

4. Salim A, Ley EJ, Berry C, Schulman D, Navarro S, Zheng L, et al. Increasing organ donation in Hispanic Americans: the role of media and other community outreach efforts. JAMA Surg. 2014; 149:71–76.

5. Doyle MB, Vachharajani N, Wellen JR, Lowell JA, Shenoy S, Ridolfi G, et al. A novel organ donor facility: a decade of experience with liver donors. Am J Transplant. 2014; 14:615–620.

6. van Smaalen TC, Hoogland ER, van Heurn LW. Machine perfusion viability testing. Curr Opin Organ Transplant. 2013; 18:168–173.

7. Marrero WJ, Naik AS, Friedewald JJ, Xu Y, Hutton DW, Lavieri MS, et al. Predictors of deceased donor kidney discard in the United States. Transplantation. [in press 2016 May 10].

8. Rosengard BR, Feng S, Alfred EJ, Zaroff JG, Emond JC, Henry ML, et al. Report of the Crystal city meeting to maximize the use of organ recovered from the cadaver donor. Am J Transplant. 2002; 2:701–711.

9. Korean Network for Organ Sharing (KONOS). 2016 Business guide on organ transplant management [Internet]. Seoul: KONOS;2016. cited 2016 Oct 21. Available from: http://konos.go.kr.

10. United Network for Organ Sharing (UNOS). Questions and answers for transplant candidates about kidney allocation [Internet]. Richmond, Va: UNOS;2016. cited 2016 Oct 11. Available from: http://www.unos.org.

11. Park UJ, Cho WH, Kim HT, Kim MY, Kim YL, Kim CD, et al. Evaluation of the Korean Network for Organ Sharing expanded donor criteria in deceased renal transplantation. J Korean Soc Transplant. 2013; 27:166–173.

12. Yang SS, Yang J, Ahn C, Min SI, Ha J, Kim SJ, et al. The need for new donor stratification to predict graft survival in deceased donor kidney transplantation. Yonsei Med J. 2017; 58:626–630.

13. Frei U, Noeldeke J, Machold-Fabrizil V, Arbogast H, Margreiter R, Fricke L, et al. Prospective age-matching in elderly kidney transplant recipients-a 5-year analysis of the Eurotransplant Senior Program. Am J Transplant. 2008; 8:50–57.

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