UNOS DonateLife

August 23, 2002

UNOS Researchers Present Findings at Transplant Meetings

Hollywood, Fla. - Researchers from the United Network for Organ Sharing (UNOS) will present several studies at the XIX International Congress of The Transplantation Society August 25 - 30 at the Westin Diplomat Resort in Hollywood, Fla. The study summaries are below. UNOS staff researchers are indicated with an asterisk.

Hormonal Resuscitation Yields More Transplanted Hearts with Improved Early Function
EMBARGOED until Thursday, August 29, 2002 at 3:45 p.m.
NOTE: As one of the top 200 abstracts accepted, the authors have been invited to submit this study for rapid review for publication in Transplantation.
Authors: John D. Rosendale, M.S.*, H. Myron Kauffman, M.D.*, Maureen A. McBride, Ph.D.*, Franki L. Chabalewski, R.N., M.S.*, Jon Zaroff, M.D., Edward Garrity, M.D., Francis L. Delmonico, M.D. and Bruce R. Rosengard, M.D.

Researchers found in a retrospective study that the use of three-drug hormonal resuscitation (hydrocortisone bolus and infusions of vasopressin and T3/T4) in the brain dead donor was associated with significantly lower risks of early graft dysfunction or mortality within one month posttransplant in heart transplant recipients. Hormonal resuscitation has recently been added to the UNOS Critical Pathway for the Organ Donor©, a donor management algorithm, previously shown in a pilot study to also be associated with an increase in the number of transplanted organs per donor. The hormonal resuscitation appears to not only maximize the number of hearts transplanted, but those hearts are also associated with better early graft function and better patient survival.

Successful U.S. OPO Donation Requestors: The Silver Lining
EMBARGOED until Monday, August 26 at noon
NOTE: UNOS offers a training workshop for organ procurement organizations, Transforming Chaos into Momentum, based on findings from this project.
Authors: Gloria J. Taylor, R.N., M.A.*, Phyllis G. Weber, R.N., CPTC, Lin J. McGaw, R.N., M.Ed.* and M. Kim Johnson, M.S.*

A series of surveys of organ procurement organization executive directors and requestors indicated that successful donation requestors are not different from other donation requestors regarding temperament and characteristic scales. Qualities that make successful donation requestors different from other requestors appear to result more from differing life experiences, training and attitudes.

Pretransplant Sensitization: Is It a Cause for Decreased Access to Cadaveric Renal Transplants Experienced by African Americans?
EMBARGOED until Monday, August 26 at noon
Alan Ting, Ph.D.* and Wida S. Cherikh, Ph.D.*

African Americans wait longer on average than Caucasians for cadaveric kidney transplants. Researchers examined the proportion of immunologically sensitized patients in these two ethnic groups to determine if pretransplant sensitization was a contributing factor. If sensitization levels were higher in African Americans than in Caucasians, this would mean that African Americans have a greater chance of having a positive crossmatch with potential donors, leading to longer waiting times. The data showed that 30.5 percent of African Americans waiting for a first transplant and 76.9 percent waiting to be retransplanted on December 31, 2001 were sensitized or highly sensitized, compared with 21.9 percent of Caucasians waiting for an initial transplant and 65.4 percent who needed to be retransplanted. The researchers concluded that African Americans tend to be more sensitized than Caucasians, and sensitization appears to be a factor in decreased access to kidney transplantation because of a greater probability of a positive crossmatch, contributing to longer waiting times for African Americans.

Trends in Living Donor Kidney Transplants: Do Minorities Benefit?
EMBARGOED until Monday, August 26 at noon
Wida S. Cherikh, Ph.D.*, Mary D. Ellison, Ph.D.* and Clive O. Callender, M.D.

Living donor kidney transplantation has become an alternative to cadaveric transplantation as the median waiting time for cadaveric kidney transplants has become longer, especially for minorities. The proportion of living donor transplants has doubled from 20 percent in 1988 to 40 percent in 2000. In a comparative study of graft outcome in minority living-donor kidney recipients, researchers found that living donor transplants resulted in a significantly lower incidence of return to dialysis within seven days of transplant and rejection, and therefore better long-term graft survival than cadaveric kidney transplants for recipients of any minority ethnic group. Although most living donors were related, living unrelated transplant recipients appeared to enjoy similar graft survival benefit as living related transplant recipients.

Donor Smoking History Associated with Increased Graft Loss in Cadaveric Kidney Transplantation
EMBARGOED until Wednesday, August 28, 2002 at noon
Wida S. Cherikh, Ph.D.*, H. Myron Kauffman, M.D.* and Anthony J. Bleyer, M.D.

In examining the impact of donor cigarette smoking history on graft and patient survival in cadaveric kidney transplant recipients, researchers found donor smoking history to be associated with a seven percent increase in risk of patient mortality. Furthermore, donors with a smoking history and a cerebrovascular cause of death were associated with a 10 percent increased risk of graft loss. The researchers concluded that increased graft loss associated with donor cigarette smoking history may be a consequence of the adverse effect of smoking on renal function.