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Deceased Donor Characteristics and Kidney Transplantation
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To the Editor: Dr Merion and colleagues1 compared survival of extended-criteria donor (ECD) and non-ECD renal transplant recipients to the best available control group: patients also listed for transplantation but not receiving a transplant. They also compared outcomes of those receiving an ECD transplant vs standard therapy. One concern with this form of registry analysis is the potential for selection bias, because patients listed for transplantation but never receiving a transplant may not be as healthy as those who are listed and subsequently receive one. A less healthy nontransplanted group would exaggerate the survival benefits of transplantation.
At the end of 2004, slightly more than 21% of listed patients were actually status 7 (not available for transplantation), in contrast to status 1 (available for transplantation).2 A common reason for status 7 is severe comorbid illness.3 At least some status 7 patients never become well enough to be status 1 and . . . [Full Text of this Article]
Colm C. Magee, MD
cmagee@partners.org
Renal Division
Brigham and Women's Hospital
Boston, Mass
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