“Nature versus Nurture” Study of Deceased-Donor Pairs in Kidney Transplantation
Open Access
- 1 June 2009
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American Society of Nephrology
- Vol. 20 (6), 1351-1358
- https://doi.org/10.1681/asn.2008070715
Abstract
Donor characteristics such as age and cause of death influence the incidence of delayed graft function (DGF) and graft survival; however, the relative influence of donor characteristics (“nature”) versus transplant center characteristics (“nurture”) on deceased-donor kidney transplant outcomes is unknown. We examined the risks for DGF and allograft failure within 19,461 recipient pairs of the same donor's kidneys using data from the US Renal Data System. For the 11,894 common-donor pairs transplanted at different centers, a recipient was twice as likely to develop DGF when the recipient of the contralateral kidney developed DGF (odds ratio [OR] 2.05; 95% confidence interval [CI] 1.82 to 2.30). Similarly, for 7567 common-donor pairs transplanted at the same center, the OR for DGF was 3.02 (95% CI 2.62 to 3.48). For pairs transplanted at the same center, there was an additional 42% risk for DGF compared with pairs transplanted at different centers. After adjustment for DGF, the within-pair ORs for allograft failure by 1 yr were 1.92 (95% CI 1.33 to 2.77) and 1.77 (95% CI 1.25 to 2.52) for recipients who underwent transplantation at the same center and different centers, respectively. These data suggest that both unmeasured donor characteristics and transplant center characteristics contribute to the risk for DGF and that the former also contribute significantly to allograft failure.Keywords
This publication has 42 references indexed in Scilit:
- Association of Donor Inflammation- and Apoptosis-Related Genotypes and Delayed Allograft Function After Kidney TransplantationAmerican Journal of Kidney Diseases, 2008
- The Transcriptome of the Implant Biopsy Identifies Donor Kidneys at Increased Risk of Delayed Graft FunctionAmerican Journal of Transplantation, 2007
- Comparison of Confidence Intervals for Adjusted Attributable Risk Estimates under Multinomial SamplingBiometrical Journal, 2006
- Chronic Allograft Nephropathy: Current Concepts and Future DirectionsTransplantation, 2006
- Utility of a Mathematical Nomogram to Predict Delayed Graft Function: A Single-Center ExperienceTransplantation, 2006
- Delayed graft function: a dilemma in renal transplantationBJU International, 2005
- Genomewide Linkage Analysis to Serum Creatinine, GFR, and Creatinine Clearance in a Community-Based PopulationJournal of the American Society of Nephrology, 2004
- Delayed function reduces renal allograft survival independent of acute rejectionNephrology Dialysis Transplantation, 1996
- Sources of Human Psychological Differences: The Minnesota Study of Twins Reared ApartScience, 1990
- RENAL TRANSPLANTATION IN THE UNITED KINGDOM AND IRELAND—THE CENTRE EFFECTThe Lancet, 1985