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3 results on '"Stocker, Felix"'

1. Kidney Transplantation after Rescue Allocation - The Eurotransplant Experience

Author

Assfalg, Volker, Miller, Gregor, Stocker, Felix, van Meel, Marieke, Groenevelt, Tiny, Tieken, Ineke, Ankerst, Donna, Renders, Lutz, Novotny, Alexander, Hartmann, Daniel, Jell, Alissa, Rahmel, Axel, Wahba, Roger, Mühlfeld, Anja, Bouts, Antonia, Ysebaert, Dirk, Globke, Brigitta, Jacobs-Tulleneers-Thevissen, Daniel, Piros, László, Stippel, Dirk, Heller, Katharina, Eisenberger, Ute, van Laecke, Steven, Weimer, Rolf, Rosenkranz, Alexander R., Berger, Stefan, Fischer, Lutz, Kliem, Volker, Vondran, Florian, Sester, Urban, Schneeberger, Stefan, Harth, Ana, Kuypers, Dirk, Függer, Reinhold, Arnol, Miha, Christiaans, Maarten, Weinmann-Menke, Julia, Krüger, Bernd, Hilbrands, Luuk, Banas, Bernhard, Hakenberg, Oliver, Minnee, Robert, Schwenger, Vedat, Heyne, Nils, van Zuilen, Arjan, Reindl-Schwaighofer, Roman, Lopau, Kai, Hüser, Norbert, Heemann, Uwe, Huüser, Norbert, Surgery, Groningen Kidney Center (GKC), Groningen Institute for Organ Transplantation (GIOT), Paediatric Nephrology, ARD - Amsterdam Reproduction and Development, Interne Geneeskunde, MUMC+: MA Nefrologie (9), RS: NUTRIM - R3 - Respiratory & Age-related Health, Pediatrics, Basic (bio-) Medical Sciences, and Diabetes Pathology & Therapy

Subjects
Waiting time, kidney, PREDICTOR, medicine.medical_specialty, Tissue and Organ Procurement, Eurotransplant, medicine.medical_treatment, Medizin, Outcome analysis, deceased donor renal transplantation, COLD ISCHEMIA TIME, surgery, All institutes and research themes of the Radboud University Medical Center, Internal medicine, DIALYSIS, Medicine and Health Sciences, Humans, Medicine, standard allocation, FRAILTY, Kidney transplantation, Dialysis, Retrospective Studies, RISK, GRAFT FAILURE, Transplantation, Deceased donor, rescue allocation, business.industry, MORTALITY, Incidence (epidemiology), Graft Survival, algorithms Eurotransplant kidney allocation system, ASSOCIATION, medicine.disease, Kidney Transplantation, Tissue Donors, Confidence interval, Eurotransplant senior program, RECIPIENTS, Treatment Outcome, SURVIVAL, Human medicine, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business
Abstract

BACKGROUND: At Eurotransplant (ET), kidneys are transferred to "rescue allocation" (RA), whenever the standard allocation (SA) algorithms Eurotransplant Kidney Allocation System (ETKAS) and Eurotransplant Senior Program (ESP) fail. We analyzed the outcome of RA. METHODS: Retrospective patient clinical and demographic characteristics association analyses were performed with graft outcomes for 2422 recipients of a deceased donor renal transplantation (DDRT) after RA versus 25 481 after SA from 71 centers across all ET countries from 2006 to 2018. RESULTS: Numbers of DDRTs after RA increased over the time, especially in Germany. RA played a minor role in ESP versus ETKAS (2.7% versus 10.4%). RA recipients and donors were older compared with SA recipients and donors, cold ischemia times were longer, waiting times were shorter, and the incidence of primary nonfunction was comparable. Among ETKAS recipients, HLA matching was more favorable in SA (mean 3.7 versus 2.5). In multivariate modeling, the incidence of graft loss in ETKAS recipients was reduced in RA compared with SA (subdistribution hazard ratio, 0.80; 95% confidence interval [0.70-0.91], P

Published
2022

2. Kidney Transplantation After Rescue Allocation-the Eurotransplant Experience: A Retrospective Multicenter Outcome Analysis

Author

Assfalg, Volker, Miller, Gregor, Stocker, Felix, van Meel, Marieke, Groenevelt, Tiny, Tieken, Ineke, Ankerst, Donna, Renders, Lutz, Novotny, Alexander, Hartmann, Daniel, Jell, Alissa, Rahmel, Axel, Wahba, Roger, Muehlfeld, Anja, Bouts, Antonia, Ysebaert, Dirk, Globke, Brigitta, Jacobs-Tulleneers-Thevissen, Daniel, Piros, Laszlo, Stippel, Dirk, Heller, Katharina, Eisenberger, Ute, van Laecke, Steven, Weimer, Rolf, Rosenkranz, Alexander R., Berger, Stefan, Fischer, Lutz, Kliem, Volker, Vondran, Florian, Sester, Urban, Schneeberger, Stefan, Harth, Ana, Kuypers, Dirk, Fuegger, Reinhold, Arnol, Miha, Christiaans, Maarten, Weinmann-Menke, Julia, Krueger, Bernd, Hilbrands, Luuk, Banas, Bernhard, Hakenberg, Oliver, Minnee, Robert, Schwenger, Vedat, Heyne, Nils, van Zuilen, Arjan, Reindl-Schwaighofer, Roman, Lopau, Kai, Hueser, Norbert, Heemann, Uwe, Assfalg, Volker, Miller, Gregor, Stocker, Felix, van Meel, Marieke, Groenevelt, Tiny, Tieken, Ineke, Ankerst, Donna, Renders, Lutz, Novotny, Alexander, Hartmann, Daniel, Jell, Alissa, Rahmel, Axel, Wahba, Roger, Muehlfeld, Anja, Bouts, Antonia, Ysebaert, Dirk, Globke, Brigitta, Jacobs-Tulleneers-Thevissen, Daniel, Piros, Laszlo, Stippel, Dirk, Heller, Katharina, Eisenberger, Ute, van Laecke, Steven, Weimer, Rolf, Rosenkranz, Alexander R., Berger, Stefan, Fischer, Lutz, Kliem, Volker, Vondran, Florian, Sester, Urban, Schneeberger, Stefan, Harth, Ana, Kuypers, Dirk, Fuegger, Reinhold, Arnol, Miha, Christiaans, Maarten, Weinmann-Menke, Julia, Krueger, Bernd, Hilbrands, Luuk, Banas, Bernhard, Hakenberg, Oliver, Minnee, Robert, Schwenger, Vedat, Heyne, Nils, van Zuilen, Arjan, Reindl-Schwaighofer, Roman, Lopau, Kai, Hueser, Norbert, and Heemann, Uwe

Abstract

Background. At Eurotransplant (ET), kidneys are transferred to rescue allocation (RA), whenever the standard allocation (SA) algorithms Eurotransplant Kidney Allocation System (ETKAS) and Eurotransplant Senior Program (ESP) fail. We analyzed the outcome of RA. Methods. Retrospective patient clinical and demographic characteristics association analyses were performed with graft outcomes for 2422 recipients of a deceased donor renal transplantation (DDRT) after RA versus 25 481 after SA from 71 centers across all ET countries from 2006 to 2018. Results. Numbers of DDRTs after RA increased over the time, especially in Germany. RA played a minor role in ESP versus ETKAS (2.7% versus 10.4%). RA recipients and donors were older compared with SA recipients and donors, cold ischemia times were longer, waiting times were shorter, and the incidence of primary nonfunction was comparable. Among ETKAS recipients, HLA matching was more favorable in SA (mean 3.7 versus 2.5). In multivariate modeling, the incidence of graft loss in ETKAS recipients was reduced in RA compared with SA (subdistribution hazard ratio, 0.80; 95% confidence interval [0.70-0.91], P < 0.001), whereas other outcomes (mortality, death with functioning graft (DwFG)) were not significantly different. None of the 3 outcomes were significantly different when comparing RA with SA within the ESP program. Conclusions. Facing increased waiting times and mortality on dialysis due to donor shortage, this study reveals encouragingly positive DDRT outcomes following RA. This supports the extension of RA to more patients and as an alternative tool to enable transplantation in patients in countries with prohibitively long waiting times or at risk of deterioration.

Published
2022

3. Rescue Allocation Modes in Eurotransplant Kidney Transplantation: Recipient Oriented Extended Allocation Versus Competitive Rescue Allocation-A Retrospective Multicenter Outcome Analysis.

Author

Assfalg V, Miller G, Stocker F, Hüser N, Hartmann D, Heemann U, Tieken I, Zanen W, Vogelaar S, Rosenkranz AR, Schneeberger S, Függer R, Berlakovich G, Ysebaert DR, Jacobs-Tulleneers-Thevissen D, Mikhalski D, van Laecke S, Kuypers D, Mühlfeld AS, Viebahn R, Pratschke J, Melchior S, Hauser IA, Jänigen B, Weimer R, Richter N, Foller S, Schulte K, Kurschat C, Harth A, Moench C, Rademacher S, Nitschke M, Krämer BK, Renders L, Koliogiannis D, Pascher A, Hoyer J, Weinmann-Menke J, Schiffer M, Banas B, Hakenberg O, Schwenger V, Nadalin S, Lopau K, Piros L, Nemes B, Szakaly P, Bouts A, Bemelman FJ, Sanders JS, de Vries APJ, Christiaans MHL, Hilbrands L, van Zuilen AD, Arnol M, Stippel D, and Wahba R

Subjects
Humans, Retrospective Studies, Male, Female, Middle Aged, Europe, Adult, Tissue and Organ Procurement, Treatment Outcome, Tissue Donors supply & distribution, Waiting Lists mortality, Time Factors, Risk Factors, Databases, Factual, Aged, Patient Selection, Kidney Transplantation mortality, Kidney Transplantation statistics & numerical data, Kidney Transplantation adverse effects, Graft Survival
Abstract

Background: Whenever the kidney standard allocation (SA) algorithms according to the Eurotransplant (ET) Kidney Allocation System or the Eurotransplant Senior Program fail, rescue allocation (RA) is initiated. There are 2 procedurally different modes of RA: recipient oriented extended allocation (REAL) and competitive rescue allocation (CRA). The objective of this study was to evaluate the association of patient survival and graft failure with RA mode and whether or not it varied across the different ET countries., Methods: The ET database was retrospectively analyzed for donor and recipient clinical and demographic characteristics in association with graft outcomes of deceased donor renal transplantation (DDRT) across all ET countries and centers from 2014 to 2021 using Cox proportional hazards methods., Results: Seventeen thousand six hundred seventy-nine renal transplantations were included (SA 15 658 [89%], REAL 860 [4.9%], and CRA 1161 [6.6%]). In CRA, donors were older, cold ischemia times were longer, and HLA matches were worse in comparison with REAL and especially SA. Multivariable analyses showed comparable graft and recipient survival between SA and REAL; however, CRA was associated with shorter graft survival. Germany performed 76% of all DDRTs after REAL and CRA and the latter mode reduced waiting times by up to 2.9 y., Conclusions: REAL and CRA are used differently in the ET countries according to national donor rates. Both RA schemes optimize graft utilization, lead to acceptable outcomes, and help to stabilize national DDRT programs, especially in Germany., Competing Interests: The authors declare no funding or conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2024
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