Predicting quality of deceased donor kidneys: the harvesting surgeon as a prognostic factor?

Introduction: The quality of donor organs is a crucial factor with regard to graft survival and function in kidney transplant recipients. The prognostic importance of surgeon-related factors during organ harvesting on graft quality has been almost unknown. Our aim was to find out whether surgical expertise as reflected by the time required for kidney retrieval influences graft survival.

Methods: In this retrospective study, we analyzed the records of 200 patients who received a cadaveric renal graft at our institution between 2000 and 2005. Graft survival and function were examined at discharge and after 1, 2, 3, and 5 years post-transplantation with the estimated glomerular filtration rate (GFR) using the Cockroft-Gault formula as a surrogate marker. We gathered the pertinent data on harvesting procedures from Eurotransplant donor reports. We correlated the length of time from cold organ perfusion to nephrectomy with graft survival. Statistical evaluation was performed using correlation analysis.

Results: There was no statistically significant correlation between the time the surgeon needed for kidney retrieval (starting from cold perfusion) and the outcome of transplantation.

Conclusion: It would seem to be obvious that the longer a cadaveric donor kidney remains in the donor's body after cold perfusion, the worse the outcome will be. Our findings, however, did not prove this hypothesis even when looking at abdominal and combined abdominal and thoracic harvesting procedures separately.