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Updated: Mar 16, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Early and Long-Term Outcomes of Kidney Grafts Procured From Multiple-Organ Donors and Kidney-Only Donors
H Cholewa1, J Chronowska1, U Kukla1
1Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, Katowice, Francuska, Poland.
Background:
The deceased-donor kidney pool consists of 2 different populations: multiple-organ donors (MOD) and kidney donors alone (KDA). In MOD, more complicated procedure and lowest priority for kidney procurement may affect graft survival. On the other hand, poor donor status and higher comorbidity are more frequent in KDA transplants. The aim of this study was to provide detailed characteristics of the 2 groups of kidney donors (KDA vs MOD) in our center and to analyze the potential influence of the donor type on the early and long-term kidney graft function and recipient outcome.
Methods:
We performed a retrospective analysis of 729 first cadaveric kidney transplant recipients: 499 of them received the organ from MOD, 230 from KDA.
Results:
The frequency of delayed graft function (DGF) was higher in KDA than in MOD transplants (38.7 vs 25.1%; P < .001). Multivariate logistic regression analysis revealed that donor age, KDA, and early acute rejection independently increased the risk of DGF occurrence, whereas recipient age and cold ischemia time increased the risk of primary graft nonfunction. Kidney excretory function was significantly worse in KDA up to 10 years after transplantation. There were no differences in kidney graft and patient survivals, frequency of proteinuria, acute rejection, and cytomegalovirus episodes, and post-transplantation diabetes.
Conclusions:
(1) The use of a kidney from KDA negatively affects early and late kidney graft function compared with MOD. (2) The long-term kidney graft and patient survivals are not affected by the type of organ procurement.
Insights
Kidneys from kidney donors alone (KDA) negatively impact early and long-term graft function compared to multiple-organ donors (MOD). However, KDA and MOD kidney transplants show similar long-term patient and graft survival rates.
Area of Science:
- Nephrology
- Transplantation Immunology
- Organ Procurement
Background:
- Deceased-donor kidneys originate from multiple-organ donors (MOD) or kidney donors alone (KDA).
- MOD kidneys may face procurement challenges, while KDA donors often have poorer health status.
- Donor type can influence kidney graft function and recipient outcomes.
Purpose of the Study:
- To characterize KDA and MOD kidney donors.
- To evaluate the impact of donor type on early and long-term kidney graft function.
- To assess the influence of donor type on recipient outcomes.
Main Methods:
- Retrospective analysis of 729 first cadaveric kidney transplant recipients.
- Comparison of outcomes between recipients of MOD (n=499) and KDA (n=230) kidneys.
- Multivariate logistic regression to identify risk factors for graft dysfunction.
Main Results:
- Delayed graft function (DGF) was more frequent in KDA transplants (38.7%) versus MOD (25.1%).
- KDA donor type, donor age, and early acute rejection independently increased DGF risk.
- Kidney excretory function was worse in KDA recipients up to 10 years post-transplant.
Conclusions:
- Kidney allografts from KDA donors demonstrate poorer early and late graft function compared to MOD.
- Graft and patient survival rates are not significantly different between KDA and MOD kidney transplant recipients in the long term.
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