Kidney transplantation from expanded criteria donors: an increased risk of urinary complications – the UriNary Complications Of Renal Transplant (UNyCORT) study. (31st August 2021)

• Record Type: Journal Article
• Authors: Mesnard, Benoit; Leroy, Maxime; Hunter, James; Kervella, Delphine; Timsit, Marc‐Olivier; Badet, Lionel; Glemain, Pascal; Morelon, Emmanuel; Buron, Fanny; Le Quintrec‐Donnette, Moglie; Pernin, Vincent; Ladriere, Marc; Girerd, Sophie; Legendre, Christophe; Sicard, Antoine; Albano, Laeticia; De Vergie, Stephane; Kerleau, Clarisse; Prudhomme, Thomas; Rigaud, Jérôme; Cantarovich, Diego; Blancho, Gilles; Karam, Georges; Giral, Magali; Ville, Simon; Branchereau, Julien
• Other Names: Badet Lionel investigator.; Brunet Maria investigator.; Buron Fanny investigator.; Cahen Rémi investigator.; Codas Ricardo investigator.; Daoud Sameh investigator.; Dubois Valérie investigator.; Fournie Coralie investigator.; Grégoire Arnaud investigator.; Koenig Alice investigator.; Lévi Charlène investigator.; Morelon Emmanuel investigator.; Pouteil‐Noble Claire investigator.; Rabeyrin Maud investigator.; Rimmelé Thomas investigator.; Thaunat Olivier investigator.; Abdo Nicolas investigator.; Delmas Sylvie investigator.; Le Quintrec Moglie investigator.; Pernin Vincent investigator.; Perrochia Hélène investigator.; Serre Jean‐Emmanuel investigator.; Szwarc Ilan investigator.; Aarnink Alice investigator.; Alla Asma investigator.; Eschwege Pascal investigator.; Frimat Luc investigator.; Girerd Sophie investigator.; Hubert Jacques investigator.; Kormann Raphaël investigator.; Ladriere Marc investigator.; Lagrange François investigator.; Laurain Emmanuelle investigator.; Lecoanet Pierre investigator.; Lemelle Jean‐Louis investigator.; Mannuguerra Anthony investigator.; Mazeaud Charles investigator.; Peres Michael investigator.; Blancho Gilles investigator.; Branchereau Julien investigator.; Cantarovich Diego investigator.; Chapelet Agnès investigator.; Dantal Jacques investigator.; Deltombe Clément investigator.; Figueres Lucile investigator.; Garandeau Claire investigator.; Giral Magali investigator.; Gourraud‐Vercel Caroline investigator.; Hourmant Maryvonne investigator.; Karam Georges investigator.; Kerleau Clarisse investigator.; Meurette Aurélie investigator.; Ville Simon investigator.; Kandell Christine investigator.; Moreau Anne investigator.; Renaudin Karine investigator.; Cesbron Anne investigator.; Delbos Florent investigator.; Walencik Alexandre investigator.; Devis Anne investigator.; Albano Laetitia investigator.; Karimi Fatimaezzahra investigator.; Sicard Antoine investigator.; Wine Thierry investigator.; Amrouche Lucile investigator.; Anglicheau Dany investigator.; Aubert Olivier investigator.; Bererhi Lynda investigator.; Legendre Christophe investigator.; Loupy Alexandre investigator.; Martinez Frank investigator.; Sberro‐Soussan Rébecca investigator.; Scemla Anne investigator.; Tinel Claire investigator.; Zuber Julien investigator.; Glotz Denis investigator.; Lefaucheur Carmen investigator.;
• Is Part Of: BJU international. Volume 129:Number 2(2022)
• Page Start: 225
• Page End: 233
• Publication Date: 2021-08-31
• Subjects: kidney transplantation -- marginal donors -- expanded criteria donor -- standard criteria donor -- donation after circulatory death -- urinary complications; Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.15509
• Languages: English
• ISSNs: 1464-4096

Abstract

Abstract : Objectives: To assess the impact of expanded criteria donors (ECD) on urinary complications in kidney transplantation. Patients and Methods: The UriNary Complications Of Renal Transplant (UNyCORT) is a cohort study based on the French prospective Données Informatisées et VAlidées en Transplantation/Computerized and VAlidated Data in Transplantation (DIVAT) cohort. Data were extracted between 1 January 2002 and 1 January 2018 with 1‐year minimum follow‐up, in relation to 44 pre‐ and postoperative variables. ECD status was included according to United Network for Organ Sharing (UNOS) definition. The primary outcome of the UNyCORT study was the association between the donor's ECD/standard criteria donors (SCD) status and urinary complications at 1 year in uni‐ and multivariate analysis. Sub‐group analysis, stratified analysis on ECD/SCD donor's status and transplant failure analysis were then conducted. Results: Between 1 January 2002 and 1 January 2018, 10 279 kidney transplants in adult recipients were recorded within the DIVAT network. A total of 8559 (83.4%) donors were deceased donors and 1699 (16.6%) were living donors (LD). Among donation after circulatory death (DCD) donors, 224 (2.85%) were uncontrolled DCD and 93 (1.09%) were controlled DCD donors. A total of 3617 (43.9%) deceased donors were ECD. The overall urological complication rate was 16.26%. The donor's ECD status was significantly associated with an increased risk of urological complications at 1 year in multivariate analysis (odds ratio: 1.50, 95% CI 1.31–1.71; P < 0.001) and especially with stenosis and ureteric fistulae at 1 year. There is no association with LD, uncontrolled and controlled DCD. The placement of an endo‐ureteric stent was beneficial in preventing urinary complications in all donors and particularly in ECD donors. Conclusion: The donor's ECD status is associated with a higher likelihood of stenosis and ureteric fistulae at 1 year. Recipients of grafts from ECD donors should probably be considered for closer urological monitoring and systematic preventive measures.