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Published on: July 15, 2015
Management of patients on the waiting list for deceased donor kidney transplantation
Insights
Kidney transplant wait-list management in Korea needs improvement. Regular comorbidity screening increases transplant chances for patients awaiting kidney transplants, highlighting the need for better patient management programs.
Area of Science:
- Nephrology
- Transplantation Medicine
- Public Health
Background:
- The number of patients on deceased donor kidney transplantation wait-lists in Korea is rising.
- No standardized management guidelines exist for these wait-listed patients.
- This study addresses the critical need for improved wait-list management strategies.
Purpose of the Study:
- To analyze the outcomes and characteristics of kidney transplant wait-listed patients in Korea.
- To identify factors influencing transplantation rates and patient survival.
- To inform the development of improved management guidelines for wait-listed individuals.
Main Methods:
- Retrospective analysis of medical records for 1,231 wait-listed patients between 2000 and 2010.
- Evaluation of patient demographics, comorbidities, screening practices, and transplantation outcomes.
- Statistical analysis to determine factors associated with transplantation success.
Main Results:
- The average waiting time for kidney transplantation was 51.9 months; 97 patients died while waiting.
- Increasing numbers of diabetic or elderly patients are registering, with less than 50% undergoing regular malignancy or cardiovascular screening.
- Regular screening was linked to a higher likelihood of receiving a transplant (P = .016), with new diagnoses of malignancy in 2.1% and cardiac ischemia in 9.7%.
Conclusions:
- Improved management programs are essential for kidney transplant wait-listed patients.
- Establishing systematic comorbidity screening is crucial for optimizing patient health and transplant eligibility.
- Patient education regarding expanded criteria donor (ECD) kidneys is necessary to increase utilization.
Background:
Although the number of wait-listed patients for deceased donor kidney transplantation has been continuously increasing in Korea, no standard guidelines exist for their management.
Methods:
We retrospectively analyzed the medical records of our 1,231 wait-listed patients between 2000 and 2010.
Results:
The time to transplantation of the 201 recipients was 51.9 ± 31.2 months. Ninety-seven patients died while waiting. Diabetic or older patients have increased among new registrants; however, <50% of them have undergone regular screening for malignancy or cardiovascular diseases. Patients with regular screening were more likely to get a chance to receive a transplant (P = .016). Malignancy was newly diagnosed in 26 patients (2.1%) and reversible cardiac ischemia was detected in 9.7%. The presence of anti-HLA antibodies was strongly associated with a lower transplantation rate, whereas blood type O was not. Although use of expanded criteria donor (ECD) kidneys increased, many patients avoided them.
Conclusion:
It is necessary to improve management programs for wait-listed patients by establishing comorbidity screening and ECD education.
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