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In Argentina, only 20% of patients on the Waiting List undergo transplants annually. For this reason, procured kidneys are a scarce resource. About 20% of the kidneys procured are discarded annually. In many cases there is a discrepancy in criteria between the Transplant Teams to accept or reject an organ. For this reason, an analysis of the evolution of the kidneys that were implanted compared to the pair that had been discarded by the rest of the Transplant teams was carried out
A retrospective, comparative analysis of the evolution of pairs of kidneys that were discarded by other transplant teams during the year 2022 in the province of Buenos Aires, Argentina was carried out. The following variables were analyzed: Survival of grafts and patients one year after transplantation (Kaplan Meier Analysis), mean and median serum creatinine of the implanted kidneys and cause of discarding of the contralateral kidneys
In 2022, 1,489 kidneys were ablated in Argentina, of which 1,173 were implanted and 316 (21.2%) were discarded. The number of kidneys discarded in the province of Buenos Aires was 162 of which 40 were unilateral. The latter was the group analyzed. The mean, median, and standard deviation pre-ablation serum creatinine were respectively 1.92 mg/dl, 1.39 mg/dl, and 1.31 (range 0.4-6.1). Functioning kidneys were 33 (82.5%). No primary function: 1, Deceased patients: 2 with functioning graft. Cause of death was cardiovascular. Four transplantectomies were performed, the causes of which were: kidney tumor (functioning graft), urinary sepsis, irreversible rejection and TAM. The reasons for discarding the contralateral kidneys were: in 17 cases prolonged ischemia time, in 16 the macroscopic appearance of the kidney, in 4 there were ablation lesions, and in the remaining three cases the biopsy, meningitis in the donor and absence of recipient. Currently functioning kidneys have a mean and median creatinine of 1.72 mg/dl and 1.41 respectively, with a Standard Deviation of 0.84 (range 0.67-5.2). The graft survival at one year is 93% and the patient's survival is 95%
When 40 implanted kidneys of the pair that were discarded were evaluated, the analysis of kidney function, graft survival and patient survival is acceptable, according to current standards. Given a scarce resource such as procured kidneys, it is necessary that objective tools be implemented in our country such as the use of clinical Score and the viability of organs with perfusion machines to make the decision to accept or reject an organ