FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 345:1237-1242 October 25, 2001 Number 17 Next

	Full Text PDF Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background The effect on allograft survival of the shipment of cadaveric renal allografts from one organ-procurement organization to another is uncertain.

Methods Using data from the Organ Procurement and Transplantation Network of the United Network for Organ Sharing, we identified 5446 pairs of cadaveric kidneys (10,892 allografts) in which one kidney was shipped and the other was transplanted locally. We compared the risk of graft failure using statistical models that accounted for confounding variables, including the degree of HLA mismatching.

Results After adjustment for the degree of HLA mismatching, shipped organs had a significantly higher rate of allograft failure than locally transplanted organs in the first year after transplantation (adjusted hazard ratio, 1.17; 95 percent confidence interval, 1.05 to 1.31; P=0.004), but not thereafter. An association between the shipment of organs with no HLA mismatches and allograft failure was not confirmed.

Conclusions The shipment of cadaveric renal allografts increases the risk of failure of HLA-mismatched grafts during the first year after transplantation.

Source Information

From the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania (K.C.M.), and the Renal–Electrolyte and Hypertension Division, Hospital of the University of Pennsylvania (K.C.M., R.D.B.) — both in Philadelphia; and the Department of Research, United Network for Organ Sharing, Richmond, Va. (W.S.C., J.M.).

Address reprint requests to Dr. Mange at 700 Clinical Research Bldg., 415 Curie Blvd., Philadelphia, PA 19104, or at kmange{at}cceb.med.upenn.edu.

Full Text of this Article

This article has been cited by other articles:

• Kessler, M., Virion, J.-M., Hachicha, M., Moulin, B., Toupance, O., Rebibou, J.-M., Guillemin, F. (2008). Effect of the shipment of cadaveric renal allografts on allograft survival. Nephrol Dial Transplant 23: 1054-1060 [Abstract] [Full Text]  
• Giraudeau, B., Halimi, J.-M., Jay, S. J., Pape, L., Offner, G., Ehrich, J. H.H., Radermacher, J., Stuht, S., Haller, H. (2003). Renal Arterial Resistance Index. NEJM 349: 1573-1574 [Full Text]  
• Mazer, S. P., Pinsky, D. J. (2002). Alive and Kicking: Endothelium at the Geographic Nexus of Vascular Rejection. Circ. Res. 91: 1085-1088 [Full Text]  
• Okada, M., Wang, C. Y., Hwang, D. W., Sakaguchi, T., Olson, K. E., Yoshikawa, Y., Minamoto, K., Mazer, S. P., Yan, S.-F., Pinsky, D. J. (2002). Transcriptional Control of Cardiac Allograft Vasculopathy by Early Growth Response Gene-1 (Egr-1). Circ. Res. 91: 135-142 [Abstract] [Full Text]  
• Koene, R. A. P. (2002). Should the allocation of cadaveric kidneys for transplantation be based on HLA matching?. Nephrol Dial Transplant 17: 717-718 [Full Text]  
• Sudhindran, S., Taylor, A., Mange, K. C., Bloom, R. D. (2002). Shipped and Locally Transplanted Renal Allografts. NEJM 346: 708-709 [Full Text]