REGIONAL VS NATIONAL RENAL SHARING ORGANIZATIONS - PROS AND CONS

Delayed graft function, defined as the need of dialysis in the first w eek after transplantation, neither due to immunological nor technical causes, determines a poor outcome of renal grafts. Delayed graft funct ion is related to the cold ischemia time, which is shorter in local al location programs. These, however, do not assure an optimal HLA-A,B,DR matching that can be provided by national allocation organizations. W e reviewed 160 cadaveric kidney grafts performed in our local transpla nt network. Owing to the long waiting list caused by organ shortage, w e were able to ensure both a high-grade histocompatibility and short c old ischemia times. The mean HLA-B,DR mismatch was 1.17. Cold ischemia time was < 24 h in 85% of cases. The incidence of DGF was 23.1%. In o ur experience a regional sharing program in the case of organ shortage provides good graft outcome (86.9% graft survival at 1 yr) with low i ncidence of delayed graft function.