short term and long term survival rate and risk factors of graft rejection after deceased donor kidney transplantation: a systematic review and meta-analysis

Introduction: the purpose of the current meta-analysis was to determine the short-term and long-term graft survival and patient survival from the deceased donors, and determine the prognostic factors.methods: pubmed, scopus, and google scholar databases were searched in march 2019 to obtain articles that report short-term and/or long-term graft and patient survival. the study also includes articles that analyzed the hazard ratio (hr) of graft rejection or patient death for deceased donor risk-related factors. the measures in this study could be summarized as the survival rate and the hr of graft rejection and patient death.results: in the final analysis, 75 articles were included. the 1- and 5-year graft survival were 90% and 76%, and patient survival was 95% and 85% respectively. the 1- and 5-year graft survival in transplant donation after brain death (dbd) for recipients were 92% and 79% and for patient survival was 94% and 90% respectively. the 1- year graft and patient survival in donation after circulatory death (dcd) recipients were 87% and 95%, respectively. also, the 1- and 5-year graft survival in patient expanded-criteria donors (ecds) were 88% and 68%, and patient survival was 93% and 87%, respectively. the 1-year graft survival in standard-criteria donors (scds) recipients was 93%, and 1- and 5-year patient survivals were 96% and 92%. age of deceased donor, ecd kidney, and male sex were the significant prognostic factors for graft rejection.conclusions: the findings of the first comprehensive meta-analysis of graft and patient survival of the deceased donor showed that the overall short-term and long-term graft and patient survival are desirable and confirm that ecd and dcd recipients have a poorer graft survival chance than standard donors.