Publication

Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death: Conclusions From a Nationwide Evaluation

Schaapherder, A., Wijermars, L. G. M., de Vries, D. K., de Vries, A. P. J., Bemelman, F. J., van de Wetering, J., van Zuilen, A. D., Christiaans, M. H. L., Hilbrands, L. H., Baas, M. C., Nurmohamed, A. S., Berger, S. P., Alwayn, I. P., Bastiaannet, E. & Lindeman, J. H. N., Oct-2019, In : EClinicalMedicine. 4-5, p. 25-31 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Schaapherder, A., Wijermars, L. G. M., de Vries, D. K., de Vries, A. P. J., Bemelman, F. J., van de Wetering, J., ... Lindeman, J. H. N. (2019). Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death: Conclusions From a Nationwide Evaluation. EClinicalMedicine, 4-5, 25-31. https://doi.org/10.1016/j.eclinm.2018.09.007

Author

Schaapherder, Alexander ; Wijermars, Leonie G M ; de Vries, Dorottya K ; de Vries, Aiko P J ; Bemelman, Frederike J ; van de Wetering, Jacqueline ; van Zuilen, Arjan D ; Christiaans, Maarten H L ; Hilbrands, Luuk H ; Baas, Marije C ; Nurmohamed, Azam S ; Berger, Stefan P ; Alwayn, Ian P ; Bastiaannet, Esther ; Lindeman, Jan H N. / Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death : Conclusions From a Nationwide Evaluation. In: EClinicalMedicine. 2019 ; Vol. 4-5. pp. 25-31.

Harvard

Schaapherder, A, Wijermars, LGM, de Vries, DK, de Vries, APJ, Bemelman, FJ, van de Wetering, J, van Zuilen, AD, Christiaans, MHL, Hilbrands, LH, Baas, MC, Nurmohamed, AS, Berger, SP, Alwayn, IP, Bastiaannet, E & Lindeman, JHN 2019, 'Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death: Conclusions From a Nationwide Evaluation', EClinicalMedicine, vol. 4-5, pp. 25-31. https://doi.org/10.1016/j.eclinm.2018.09.007

Standard

Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death : Conclusions From a Nationwide Evaluation. / Schaapherder, Alexander; Wijermars, Leonie G M; de Vries, Dorottya K; de Vries, Aiko P J; Bemelman, Frederike J; van de Wetering, Jacqueline; van Zuilen, Arjan D; Christiaans, Maarten H L; Hilbrands, Luuk H; Baas, Marije C; Nurmohamed, Azam S; Berger, Stefan P; Alwayn, Ian P; Bastiaannet, Esther; Lindeman, Jan H N.

In: EClinicalMedicine, Vol. 4-5, 10.2019, p. 25-31.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Schaapherder A, Wijermars LGM, de Vries DK, de Vries APJ, Bemelman FJ, van de Wetering J et al. Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death: Conclusions From a Nationwide Evaluation. EClinicalMedicine. 2019 Oct;4-5:25-31. https://doi.org/10.1016/j.eclinm.2018.09.007


BibTeX

@article{ac82aba144534fddb9e7ae18c411b189,
title = "Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death: Conclusions From a Nationwide Evaluation",
abstract = "Background: Despite growing waiting lists for renal transplants, hesitations persist with regard to the use of deceased after cardiac death (DCD) renal grafts. We evaluated the outcomes of DCD donations in The Netherlands, the country with the highest proportion of DCD procedures (42.9{\%}) to test whether these hesitations are justified.Methods: This study included all procedures with grafts donated after brain death (DBD) (n = 3611) and cardiac death (n = 2711) performed between 2000 and 2017. Transplant outcomes were compared by Kaplan Meier and Cox regression analysis, and factors associated with short (within 90 days of transplantation) and long-term graft loss evaluated in multi-variable analyses.Findings: Despite higher incidences of early graft loss (+ 50{\%}) and delayed graft function (+ 250{\%}) in DCD grafts, 10-year graft and recipient survival were similar for the two graft types (Combined 10-year graft survival: 73.9{\%} (95{\%} CI: 72.5-75.2), combined recipient survival: 64.5{\%} (95 CI: 63.0-66.0{\%})). Long-term outcome equivalence was explained by a reduced impact of delayed graft function on DCD graft survival (RR: 0.69 (95{\%} CI: 0.55-0.87), p < 0.001). Mid and long-term graft function (eGFR), and the impact of incident delayed graft function on eGFR were similar for DBD and DCD grafts.Interpretation: Mid and long term outcomes for DCD grafts are equivalent to DBD kidneys. Poorer short term outcomes are offset by a lesser impact of delayed graft function on DCD graft survival. This nation-wide evaluation does not justify the reluctance to use of DCD renal grafts. A strong focus on short-term outcome neglects the superior recovery potential of DCD grafts.",
author = "Alexander Schaapherder and Wijermars, {Leonie G M} and {de Vries}, {Dorottya K} and {de Vries}, {Aiko P J} and Bemelman, {Frederike J} and {van de Wetering}, Jacqueline and {van Zuilen}, {Arjan D} and Christiaans, {Maarten H L} and Hilbrands, {Luuk H} and Baas, {Marije C} and Nurmohamed, {Azam S} and Berger, {Stefan P} and Alwayn, {Ian P} and Esther Bastiaannet and Lindeman, {Jan H N}",
year = "2019",
month = "10",
doi = "10.1016/j.eclinm.2018.09.007",
language = "English",
volume = "4-5",
pages = "25--31",
journal = "EClinicalMedicine",
issn = "2589-5370",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death

T2 - Conclusions From a Nationwide Evaluation

AU - Schaapherder, Alexander

AU - Wijermars, Leonie G M

AU - de Vries, Dorottya K

AU - de Vries, Aiko P J

AU - Bemelman, Frederike J

AU - van de Wetering, Jacqueline

AU - van Zuilen, Arjan D

AU - Christiaans, Maarten H L

AU - Hilbrands, Luuk H

AU - Baas, Marije C

AU - Nurmohamed, Azam S

AU - Berger, Stefan P

AU - Alwayn, Ian P

AU - Bastiaannet, Esther

AU - Lindeman, Jan H N

PY - 2019/10

Y1 - 2019/10

N2 - Background: Despite growing waiting lists for renal transplants, hesitations persist with regard to the use of deceased after cardiac death (DCD) renal grafts. We evaluated the outcomes of DCD donations in The Netherlands, the country with the highest proportion of DCD procedures (42.9%) to test whether these hesitations are justified.Methods: This study included all procedures with grafts donated after brain death (DBD) (n = 3611) and cardiac death (n = 2711) performed between 2000 and 2017. Transplant outcomes were compared by Kaplan Meier and Cox regression analysis, and factors associated with short (within 90 days of transplantation) and long-term graft loss evaluated in multi-variable analyses.Findings: Despite higher incidences of early graft loss (+ 50%) and delayed graft function (+ 250%) in DCD grafts, 10-year graft and recipient survival were similar for the two graft types (Combined 10-year graft survival: 73.9% (95% CI: 72.5-75.2), combined recipient survival: 64.5% (95 CI: 63.0-66.0%)). Long-term outcome equivalence was explained by a reduced impact of delayed graft function on DCD graft survival (RR: 0.69 (95% CI: 0.55-0.87), p < 0.001). Mid and long-term graft function (eGFR), and the impact of incident delayed graft function on eGFR were similar for DBD and DCD grafts.Interpretation: Mid and long term outcomes for DCD grafts are equivalent to DBD kidneys. Poorer short term outcomes are offset by a lesser impact of delayed graft function on DCD graft survival. This nation-wide evaluation does not justify the reluctance to use of DCD renal grafts. A strong focus on short-term outcome neglects the superior recovery potential of DCD grafts.

AB - Background: Despite growing waiting lists for renal transplants, hesitations persist with regard to the use of deceased after cardiac death (DCD) renal grafts. We evaluated the outcomes of DCD donations in The Netherlands, the country with the highest proportion of DCD procedures (42.9%) to test whether these hesitations are justified.Methods: This study included all procedures with grafts donated after brain death (DBD) (n = 3611) and cardiac death (n = 2711) performed between 2000 and 2017. Transplant outcomes were compared by Kaplan Meier and Cox regression analysis, and factors associated with short (within 90 days of transplantation) and long-term graft loss evaluated in multi-variable analyses.Findings: Despite higher incidences of early graft loss (+ 50%) and delayed graft function (+ 250%) in DCD grafts, 10-year graft and recipient survival were similar for the two graft types (Combined 10-year graft survival: 73.9% (95% CI: 72.5-75.2), combined recipient survival: 64.5% (95 CI: 63.0-66.0%)). Long-term outcome equivalence was explained by a reduced impact of delayed graft function on DCD graft survival (RR: 0.69 (95% CI: 0.55-0.87), p < 0.001). Mid and long-term graft function (eGFR), and the impact of incident delayed graft function on eGFR were similar for DBD and DCD grafts.Interpretation: Mid and long term outcomes for DCD grafts are equivalent to DBD kidneys. Poorer short term outcomes are offset by a lesser impact of delayed graft function on DCD graft survival. This nation-wide evaluation does not justify the reluctance to use of DCD renal grafts. A strong focus on short-term outcome neglects the superior recovery potential of DCD grafts.

U2 - 10.1016/j.eclinm.2018.09.007

DO - 10.1016/j.eclinm.2018.09.007

M3 - Article

VL - 4-5

SP - 25

EP - 31

JO - EClinicalMedicine

JF - EClinicalMedicine

SN - 2589-5370

ER -

ID: 90001580