Management of patients on the waiting list for deceased donor kidney transplantation

Background: Although the number of wait-listed patients for deceased donor kidney transplantation has been continuously increasing in Korea, no standard guidelines exist for their management. Methods: We retrospectively analyzed the medical records of our 1,231 wait-listed patients between 2000 and 2010. Results: The time to transplantation of the 201 recipients was 51.9 ± 31.2 months. Ninety-seven patients died while waiting. Diabetic or older patients have increased among new registrants; however, <50% of them have undergone regular screening for malignancy or cardiovascular diseases. Patients with regular screening were more likely to get a chance to receive a transplant (P =.016). Malignancy was newly diagnosed in 26 patients (2.1%) and reversible cardiac ischemia was detected in 9.7%. The presence of anti-HLA antibodies was strongly associated with a lower transplantation rate, whereas blood type O was not. Although use of expanded criteria donor (ECD) kidneys increased, many patients avoided them. Conclusion: It is necessary to improve management programs for wait-listed patients by establishing comorbidity screening and ECD education.