Parmentier-de LC, Cruz-Martínez R, Toapanta-Yanchapaxi L, Chiquete E, Quintero-Quintero MJ, García-Baysa M, López-Jiménez JL, Martínez-Cabrera C, Solis-Gamboa MI, Ramírez-Espinoza C, Martínez-Juárez IA, Morales-Buenrostro LE, Uribe-Uribe NO, Contreras AG, Alberú J, Vilatobá M

Language: Spanish
References: 21
Page: 25-34
PDF size: 351.40 Kb.

ABSTRACT

Introduction: The growing worldwide disproportion between the number of patients in the kidney waiting list and the number of allografts from deceased donors, forces us to look for strategies to extend and optimize the kidney graft allocation. These strategies are also trying to diminish the number of discarded organs. Material and methods: Through the review of the available literature, we created an algorithm for kidney allocation. We analyzed all the relevant information from deceased donors from January 2012 to April 2018 at our institution, in a retrospective manner, to test the algorithm's performance. Results: A total of 123 deceased donors were identified, 3 were excluded, which gave us a total of 200 allografts. According to the algorithm, 57 kidneys would have required a preimplantation biopsy and 17 of 57 would have required dual kidney transplant (none was transplanted as dual). The allograft survival according to the need of dual transplantation was statistically significant (p = 0.038). A glomerular filtration rate, using MDRD formula, of ≤ 50 mL/min at one-year post transplantation, was significantly less in patients that needed a dual kidney transplantation and didn't get one (p = 0.008). A KDPI equal or higher than 82% was the cutoff point for our cohort unlike the 85% reported in other papers (p = 0.022). Conclusions: There are multiple algorithms worldwide for kidney allocation. To our knowledge this is the first one created for Mexican population. We firmly believe that our algorithm has great potential for better allocation of kidneys, by avoiding unnecessary discard of functional allografts that could be transplanted as dual in the appropriate recipients.

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