Longer-Term Outcomes After Kidney Transplantation From Seronegative Deceased Donors at Increased Risk for Blood-Borne Viral Infection
Transmission of human immunodeficiency virus and hepatitis C to transplant recipients has drawn attention of the use of allografts from seronegative donors at increased risk for blood-borne viral infection (DIRVI). We performed a cohort study of 7803 kidney transplant recipients whose kidneys were r...
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| Veröffentlicht in: | Transplantation 2011-06, Vol.91 (11), p.1211-1217 |
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| creator | REESE, Peter P HALPERN, Scott D DELAURO, Gina BLUMBERG, Emily WENG, Francis L CAPLAN, Arthur THOMASSON, Arwin SHULTS, Justine FELDMAN, Harold I ASCH, David A BLOOM, Roy NATHAN, Howard HASZ, Richard ROTH, Joseph REITSMA, William KREFSKI, Louis GOERLITZ, Fred |
| description | Transmission of human immunodeficiency virus and hepatitis C to transplant recipients has drawn attention of the use of allografts from seronegative donors at increased risk for blood-borne viral infection (DIRVI).
We performed a cohort study of 7803 kidney transplant recipients whose kidneys were recovered through one of two organ procurement organizations from 1996 to 2007. Detailed organ procurement organization data on donor risk factors were linked to recipient data from the Organ Procurement and Transplantation Network.
Median recipient follow-up was 3.9 years. Three hundred sixty-eight (5%) patients received DIRVI kidneys, a third of which were procured from donors with a history of injection drug use or commercial sex work. Compared with standard criteria kidney recipients, DIRVI kidney recipients were more likely to be human immunodeficiency virus positive or black. In multivariable Cox regression, using DIRVI recipients as the reference, recipients of standard criteria donor kidneys had lower mortality (hazard ratio [HR] 0.71, P |
| doi_str_mv | 10.1097/TP.0b013e318218d59a |
| format | Article |
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We performed a cohort study of 7803 kidney transplant recipients whose kidneys were recovered through one of two organ procurement organizations from 1996 to 2007. Detailed organ procurement organization data on donor risk factors were linked to recipient data from the Organ Procurement and Transplantation Network.
Median recipient follow-up was 3.9 years. Three hundred sixty-eight (5%) patients received DIRVI kidneys, a third of which were procured from donors with a history of injection drug use or commercial sex work. Compared with standard criteria kidney recipients, DIRVI kidney recipients were more likely to be human immunodeficiency virus positive or black. In multivariable Cox regression, using DIRVI recipients as the reference, recipients of standard criteria donor kidneys had lower mortality (hazard ratio [HR] 0.71, P<0.01) and no difference in death-censored allograft failure (HR 1.09, P=0.62), whereas recipients of expanded criteria donor kidneys had no significant difference in mortality (HR 0.98, P=0.83) but a higher allograft failure rate (HR 1.93, P<0.01). High-quality data on posttransplant recipient viral testing were not available.
DIRVI kidney recipients experienced higher mortality than standard criteria kidney recipients. This finding could be explained if sicker patients received DIRVI kidneys (i.e., residual confounding) or the less likely possibility of undetected transmission of viral infections. Given the limitations of registry data used in this analysis, prospective studies are needed to further elucidate these findings.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/TP.0b013e318218d59a</identifier><identifier>PMID: 21527872</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Biological and medical sciences ; Data processing ; Death ; Donors ; Female ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Human immunodeficiency virus ; Humans ; Immunosuppressive agents ; Infection ; Infectious diseases ; Kidney transplantation ; Kidney Transplantation - adverse effects ; Kidney Transplantation - mortality ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Mortality ; Risk Factors ; Sex ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Tissue Donors ; Tissue, organ and graft immunology ; Transplantation, Homologous ; Treatment Outcome ; Viral diseases ; Viremia - etiology ; Virus Diseases - blood ; Virus Diseases - etiology</subject><ispartof>Transplantation, 2011-06, Vol.91 (11), p.1211-1217</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-1822a2d5d3befd15605413d89c036f9b4e5609fd5de6c03e2b1b692abb7d910a3</citedby><cites>FETCH-LOGICAL-c467t-1822a2d5d3befd15605413d89c036f9b4e5609fd5de6c03e2b1b692abb7d910a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24277002$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21527872$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>REESE, Peter P</creatorcontrib><creatorcontrib>HALPERN, Scott D</creatorcontrib><creatorcontrib>DELAURO, Gina</creatorcontrib><creatorcontrib>BLUMBERG, Emily</creatorcontrib><creatorcontrib>WENG, Francis L</creatorcontrib><creatorcontrib>CAPLAN, Arthur</creatorcontrib><creatorcontrib>THOMASSON, Arwin</creatorcontrib><creatorcontrib>SHULTS, Justine</creatorcontrib><creatorcontrib>FELDMAN, Harold I</creatorcontrib><creatorcontrib>ASCH, David A</creatorcontrib><creatorcontrib>BLOOM, Roy</creatorcontrib><creatorcontrib>NATHAN, Howard</creatorcontrib><creatorcontrib>HASZ, Richard</creatorcontrib><creatorcontrib>ROTH, Joseph</creatorcontrib><creatorcontrib>REITSMA, William</creatorcontrib><creatorcontrib>KREFSKI, Louis</creatorcontrib><creatorcontrib>GOERLITZ, Fred</creatorcontrib><title>Longer-Term Outcomes After Kidney Transplantation From Seronegative Deceased Donors at Increased Risk for Blood-Borne Viral Infection</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>Transmission of human immunodeficiency virus and hepatitis C to transplant recipients has drawn attention of the use of allografts from seronegative donors at increased risk for blood-borne viral infection (DIRVI).
We performed a cohort study of 7803 kidney transplant recipients whose kidneys were recovered through one of two organ procurement organizations from 1996 to 2007. Detailed organ procurement organization data on donor risk factors were linked to recipient data from the Organ Procurement and Transplantation Network.
Median recipient follow-up was 3.9 years. Three hundred sixty-eight (5%) patients received DIRVI kidneys, a third of which were procured from donors with a history of injection drug use or commercial sex work. Compared with standard criteria kidney recipients, DIRVI kidney recipients were more likely to be human immunodeficiency virus positive or black. In multivariable Cox regression, using DIRVI recipients as the reference, recipients of standard criteria donor kidneys had lower mortality (hazard ratio [HR] 0.71, P<0.01) and no difference in death-censored allograft failure (HR 1.09, P=0.62), whereas recipients of expanded criteria donor kidneys had no significant difference in mortality (HR 0.98, P=0.83) but a higher allograft failure rate (HR 1.93, P<0.01). High-quality data on posttransplant recipient viral testing were not available.
DIRVI kidney recipients experienced higher mortality than standard criteria kidney recipients. This finding could be explained if sicker patients received DIRVI kidneys (i.e., residual confounding) or the less likely possibility of undetected transmission of viral infections. Given the limitations of registry data used in this analysis, prospective studies are needed to further elucidate these findings.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Data processing</subject><subject>Death</subject><subject>Donors</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>Infection</subject><subject>Infectious diseases</subject><subject>Kidney transplantation</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Kidney Transplantation - mortality</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Risk Factors</subject><subject>Sex</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Tissue Donors</subject><subject>Tissue, organ and graft immunology</subject><subject>Transplantation, Homologous</subject><subject>Treatment Outcome</subject><subject>Viral diseases</subject><subject>Viremia - etiology</subject><subject>Virus Diseases - blood</subject><subject>Virus Diseases - etiology</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctuFDEQRS0EIkPgC5CQNwg2HcqPtrs3SHkQiBgpEQxsLbddPTR024PdEykfwH_jaIbwWLAq6dapq6q6hDxlcMSg1a9WV0fQARMoWMNZ4-vW3iMLVgtZKWjgPlkASFYxIfQBeZTzVwCohdYPyQFnNdeN5gvyYxnDGlO1wjTRy-3s4oSZHvczJvp-8AFv6CrZkDejDbOdhxjoeYoT_YgpBlwX5RrpGTq0GT09iyGmTO1ML4JLO-3DkL_RPiZ6Msboq5OYAtLPQ7JjgXp0t56PyYPejhmf7Osh-XT-ZnX6rlpevr04PV5WTio9V-VObrmvveiw96xWUEsmfNM6EKpvO4lFavsCoCoS8o51quW267RvGVhxSF7vfDfbbkLvMMxlD7NJw2TTjYl2MH93wvDFrOO1EVJxKWUxeLE3SPH7FvNspiE7HMt3MG6zabSWjCmmC_nyvyQDaBqhVCsKKnaoSzHnhP3dQgzMbdRmdWX-jbpMPfvzlruZX9kW4PkesNnZsS8xuiH_5iTXGoCLnyAJtQc</recordid><startdate>20110615</startdate><enddate>20110615</enddate><creator>REESE, Peter P</creator><creator>HALPERN, Scott D</creator><creator>DELAURO, Gina</creator><creator>BLUMBERG, Emily</creator><creator>WENG, Francis L</creator><creator>CAPLAN, Arthur</creator><creator>THOMASSON, Arwin</creator><creator>SHULTS, Justine</creator><creator>FELDMAN, Harold I</creator><creator>ASCH, David A</creator><creator>BLOOM, Roy</creator><creator>NATHAN, Howard</creator><creator>HASZ, Richard</creator><creator>ROTH, Joseph</creator><creator>REITSMA, William</creator><creator>KREFSKI, Louis</creator><creator>GOERLITZ, Fred</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20110615</creationdate><title>Longer-Term Outcomes After Kidney Transplantation From Seronegative Deceased Donors at Increased Risk for Blood-Borne Viral Infection</title><author>REESE, Peter P ; HALPERN, Scott D ; DELAURO, Gina ; BLUMBERG, Emily ; WENG, Francis L ; CAPLAN, Arthur ; THOMASSON, Arwin ; SHULTS, Justine ; FELDMAN, Harold I ; ASCH, David A ; BLOOM, Roy ; NATHAN, Howard ; HASZ, Richard ; ROTH, Joseph ; REITSMA, William ; KREFSKI, Louis ; GOERLITZ, Fred</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-1822a2d5d3befd15605413d89c036f9b4e5609fd5de6c03e2b1b692abb7d910a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Data processing</topic><topic>Death</topic><topic>Donors</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Immunosuppressive agents</topic><topic>Infection</topic><topic>Infectious diseases</topic><topic>Kidney transplantation</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Kidney Transplantation - mortality</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Risk Factors</topic><topic>Sex</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Tissue Donors</topic><topic>Tissue, organ and graft immunology</topic><topic>Transplantation, Homologous</topic><topic>Treatment Outcome</topic><topic>Viral diseases</topic><topic>Viremia - etiology</topic><topic>Virus Diseases - blood</topic><topic>Virus Diseases - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>REESE, Peter P</creatorcontrib><creatorcontrib>HALPERN, Scott D</creatorcontrib><creatorcontrib>DELAURO, Gina</creatorcontrib><creatorcontrib>BLUMBERG, Emily</creatorcontrib><creatorcontrib>WENG, Francis L</creatorcontrib><creatorcontrib>CAPLAN, Arthur</creatorcontrib><creatorcontrib>THOMASSON, Arwin</creatorcontrib><creatorcontrib>SHULTS, Justine</creatorcontrib><creatorcontrib>FELDMAN, Harold I</creatorcontrib><creatorcontrib>ASCH, David A</creatorcontrib><creatorcontrib>BLOOM, Roy</creatorcontrib><creatorcontrib>NATHAN, Howard</creatorcontrib><creatorcontrib>HASZ, Richard</creatorcontrib><creatorcontrib>ROTH, Joseph</creatorcontrib><creatorcontrib>REITSMA, William</creatorcontrib><creatorcontrib>KREFSKI, Louis</creatorcontrib><creatorcontrib>GOERLITZ, Fred</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>REESE, Peter P</au><au>HALPERN, Scott D</au><au>DELAURO, Gina</au><au>BLUMBERG, Emily</au><au>WENG, Francis L</au><au>CAPLAN, Arthur</au><au>THOMASSON, Arwin</au><au>SHULTS, Justine</au><au>FELDMAN, Harold I</au><au>ASCH, David A</au><au>BLOOM, Roy</au><au>NATHAN, Howard</au><au>HASZ, Richard</au><au>ROTH, Joseph</au><au>REITSMA, William</au><au>KREFSKI, Louis</au><au>GOERLITZ, Fred</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Longer-Term Outcomes After Kidney Transplantation From Seronegative Deceased Donors at Increased Risk for Blood-Borne Viral Infection</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2011-06-15</date><risdate>2011</risdate><volume>91</volume><issue>11</issue><spage>1211</spage><epage>1217</epage><pages>1211-1217</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>Transmission of human immunodeficiency virus and hepatitis C to transplant recipients has drawn attention of the use of allografts from seronegative donors at increased risk for blood-borne viral infection (DIRVI).
We performed a cohort study of 7803 kidney transplant recipients whose kidneys were recovered through one of two organ procurement organizations from 1996 to 2007. Detailed organ procurement organization data on donor risk factors were linked to recipient data from the Organ Procurement and Transplantation Network.
Median recipient follow-up was 3.9 years. Three hundred sixty-eight (5%) patients received DIRVI kidneys, a third of which were procured from donors with a history of injection drug use or commercial sex work. Compared with standard criteria kidney recipients, DIRVI kidney recipients were more likely to be human immunodeficiency virus positive or black. In multivariable Cox regression, using DIRVI recipients as the reference, recipients of standard criteria donor kidneys had lower mortality (hazard ratio [HR] 0.71, P<0.01) and no difference in death-censored allograft failure (HR 1.09, P=0.62), whereas recipients of expanded criteria donor kidneys had no significant difference in mortality (HR 0.98, P=0.83) but a higher allograft failure rate (HR 1.93, P<0.01). High-quality data on posttransplant recipient viral testing were not available.
DIRVI kidney recipients experienced higher mortality than standard criteria kidney recipients. This finding could be explained if sicker patients received DIRVI kidneys (i.e., residual confounding) or the less likely possibility of undetected transmission of viral infections. Given the limitations of registry data used in this analysis, prospective studies are needed to further elucidate these findings.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>21527872</pmid><doi>10.1097/TP.0b013e318218d59a</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | Journals@Ovid Ovid Autoload; MEDLINE |
| subjects | Adult Biological and medical sciences Data processing Death Donors Female Fundamental and applied biological sciences. Psychology Fundamental immunology Human immunodeficiency virus Humans Immunosuppressive agents Infection Infectious diseases Kidney transplantation Kidney Transplantation - adverse effects Kidney Transplantation - mortality Logistic Models Male Medical sciences Middle Aged Mortality Risk Factors Sex Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Tissue Donors Tissue, organ and graft immunology Transplantation, Homologous Treatment Outcome Viral diseases Viremia - etiology Virus Diseases - blood Virus Diseases - etiology |
| title | Longer-Term Outcomes After Kidney Transplantation From Seronegative Deceased Donors at Increased Risk for Blood-Borne Viral Infection |
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