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Keywords:

  • Analysis of Australia and New Zealand Dialysis and Transplant Registry;
  • graft survival;
  • rejection;
  • renal transplant;
  • shipped

ABSTRACT:

Aim:  Allocation of deceased-donor kidneys in Australia often involves the shipping of well-matched renal allografts across states. However, the impact of shipping on graft outcomes remains unclear. In this study, the effect of shipping of well-matched (0–2 human leucocyte antigen (HLA) mismatches) and poorer-matched (3–6 HLA mismatches) deceased-donor kidneys on transplant outcomes in Australia were examined.

Methods:  Using data from Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), graft and patient outcomes were compared between shipped and locally transplanted allografts in Australia between 1992 and 2007 stratified by the number of HLA mismatches.

Results:  Recipients receiving shipped renal allografts were more likely to be highly sensitized with previous grafts and/or higher panel reactive antibodies levels with significantly longer graft ischaemic time compared to local allografts. Regardless of the HLA mismatches, the risk of delayed graft function, acute rejection, 12 month serum creatinine, graft failure and patient survival was similar between shipped and locally transplanted renal allografts.

Conclusion:  Recipients of shipped renal allografts with 0–2 and 3–6 HLA mismatches have similar transplant outcomes to locally transplanted allografts.