THE OUTCOME OF KIDNEY GRAFTS FROM MULTIORGAN DONORS AND KIDNEY ONLY DONORS

From 1988 to 1994, 15356 renal cadaveric transplantations have been pe rformed within the Eurotransplant area (Austria, Belgium, Germany, Lux embourg and The Netherlands); 8746 kidneys were obtained from multiorg an donors and 6610 from kidney only donors, To evaluate the impact of the procurement policy, multiorgan donor (MOD) versus kidney only dono r (KOD), on renal graft survival, an observational study has been perf ormed, Multivariate analysis using Cox's proportional hazards model se rved to quantify the role of the procurement policy on renal graft sur vival after adjustment for other prognostic factors, The kidneys obtai ned from MODs had a significantly better graft survival at 1, 3, and 5 years after transplantation than the kidneys obtained from KODs (85%, 75%, and 58% versus 78%, 68%, and 46% (P = 0.0001). In the Cox model, patients transplanted with a KOD kidney had a 1.28 times higher risk of losing their graft than patients transplanted with a MOD kidney. Th is benefit in graft survival for MOD kidneys could not be explained by the fact that the MODs were younger and male, and that UW was used as preservation solution, A plausible explanation is that MODs, on avera ge, because of the nonrenal transplants, are better supervised, We exp ect that optimal donor management will contribute to a better outcome of all renal grafts.