Preemptive living donor kidney transplantation: Access, fate, and review of the status in Egypt

Table 1 A comparison of the demographic and clinical characteristics of the patients with preemptive access to kidney transplantation and those with conventional access to kidney transplantation, n (%)

Variables	PAKT, n = 32	CAKT, n = 272	P value
Age in yr, mean ± SD (range)	31.7 ± 13 (13-60)	32.1 ± 11.5 (12-66)	0.677
Sex
Men	22 (68.8)	213 (78.3)	0.263
Women	10 (31.2)	59 (21.7)
Primary kidney disease
Glomerulonephritis	3 (9.4)	8 (2.9)	< 0.001
Hereditary disease	3 (9.4)	6 (2.2)
Obstructive uropathy	4 (12.5)	8 (2.9)
Systemic disease	4 (12.5)	14 (5.2)
Urolithiasis	3 (9.4)	7 (2.6)
Unknown	15 (46.9)	229 (84.2)
Number of potential donors1
Patients presented without donors	8 (25)	36 (13.2)	0.088
With one donor	17 (53.1)	187 (68.8)
With two donors	4 (12.5)	40 (14.7)
With three donors	3 (9.4)	9 (3.3)
Donor evaluation	24	236
Patients with evaluated donors	20	194
With accepted donor(s)	10 (50)	89 (45.9)	0.232
With one donor excluded	7 (35)	75 (38.7)
With two donors excluded	0 (0)	15 (7.7)
With three donors excluded	1 (5)	2 (1)
With excluded and accepted donors	2 (10)	13 (6.7)
Number of not evaluated donors per patient	6	56
One donor	3 (50)	51 (91.1)	0.024
Two donors	3 (50)	4 (7.1)
Three donors	0 (0)	1 (1.8)
Order of the accepted donor	12	102
First	10 (83.3)	87 (85.3)	0.634
Second	1 (8.3)	11 (10.8)
Third	1 (8.3)	4 (3.9)
Accepted donor age (yr), mean ± SD (range)	38.1 ± 9 (25-53)	40.6 ± 10.4 (21-60)	0.39
Patient-donor relatedness degree
First	5 (41.7)	55 (53.9)	0.234
Second	5 (41.7)	40 (39.2)
Third	1 (8.3)	6 (5.9)
Unrelated	1 (8.3)	1 (1)
Sex of accepted donors
Women	7 (58.3)	66 (64.7)	0.754
Men	5 (41.7)	36 (35.3)
Accepted donor commitment
Donated	4 (33.3)	55 (53.9)	0.171
Regressed	1 (8.3)	16 (15.7)
Released	7 (58.3)	31 (30.4)
Number of excluded donors per patient
One donor	7 (77.8)	84 (80)	0.262
Two donors	1 (11.1)	19 (18.1)
Three donors	1 (11.1)	2 (1.9)
Main causes of donor exclusion
Medical causes	1 (10)	51 (51.5)	0.027
Immunologic mismatch	7 (70)	34 (34.3)
Combined medical and immunologic	2 (20)	14 (14.1)
Main causes of donor release	5	28
Financial causes	0 (0)	3 (10.7)	0.235
Patient death	0 (0)	3 (10.7)
Patient non-candidacy	0 (0)	10 (35.7)
Patient regression	5 (100)	12 (42.9)
Achievement of kidney transplantation
Failed	25 (78.1)	191 (70.2)	0.568
Transplanted in our center	4 (12.5)	55 (20.2)
Transplanted in another center	3 (9.4)	26 (9.6)
Cause of non-achievement of transplantation in our center	28	191
Donor exclusion	8 (28.6)	88 (40.6)	0.035
Donor regression	1 (3.6)	16 (7.4)
Donor unavailability	7 (25)	37 (17.1)
Financial causes	1 (3.6)	13 (5.6)
Patient non-candidacy	0 (0)	25 (11.5)
Patient death	0 (0)	5 (2.6)
Patient regression	11 (39.3)	33 (15.2)
Fate of recipients who failed to have transplantation in our center
Death	0 (0)	13 (6)	0.213
On hemodialysis	24 (85.7)	147 (67.7)
Transplantation in another center	3 (10.7)	26 (12)
Unknown	1 (3.6)	31 (14.3)

¹The headings of the donor evaluation and non-evaluation may include overlapping numbers due to different outcomes of the evaluation of multiple donors, resulting in non-complementary values relative to the total number of patients in both groups.

CAKT: Conventional access to kidney transplantation; PAKT: Preemptive access to kidney transplantation; SD: Standard deviation.