Development and outcomes of surgical and urological kidney transplantation programs in Germany: a total population analysis from 2006 to 2021 - Scorecard - MDSpire
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Development and outcomes of surgical and urological kidney transplantation programs in Germany: a total population analysis from 2006 to 2021
Kidney transplantation from deceased or living donors to replace renal function
Target Population
Patients with end-stage renal disease in Germany
Care Setting
Urology and visceral surgery departments in German hospitals
Key Highlights
Between 2006 and 2021, 23,599 kidney transplants were performed in Germany, with 75.3% from deceased donors and 24.7% from living donors.
The annual number of kidney transplants in urology departments decreased by 33.3%, while visceral surgery departments maintained stable transplant numbers.
Complication rates for deceased donor kidney transplants between 2013 and 2019 were similar in urology and surgery departments (~19%) with no significant difference.
Guideline-Based Recommendations
Diagnosis
Identify candidates for kidney transplantation based on end-stage renal disease status.
Management
Perform kidney transplantation either from deceased donors (DDKT) or living donors (LDKT).
Maintain high-load transplant centers with >25 KTs and >5 LDKTs annually for certification.
Monitoring & Follow-up
Monitor intra- and postoperative complications defined as severe events requiring blood transfusion or revision surgery.
Assess graft function immediately post-transplant by dialysis requirement and graft quality by GFR ≥ 20 ml/min at discharge and one year.
Risks
Severe intra- and postoperative complications may require revision surgery or blood transfusion.
Potential decline in transplant numbers in urology departments may impact access to care.
Patient & Prescribing Data
Patients undergoing kidney transplantation in Germany from 2006 to 2021.
Stable complication rates across urology and surgery departments suggest comparable safety profiles; however, urology departments showed a decline in transplant volume.
Clinical Best Practices
Maintain certification standards by ensuring transplant centers perform adequate annual caseloads (>25 KTs and >5 LDKTs).
Use standardized definitions for complications and graft function to enable consistent outcome monitoring.
Encourage collaboration between urology and surgery departments to optimize transplant program performance.
Utilize national quality reports and organ procurement data for continuous quality improvement.
by Philipp Reimold, Cem Aksoy, Jonas Beckmann, Aristeidis Zacharis, Christer Groeben, Philipp Karschuck, Nicole Eisenmenger, Josef Geks, Johannes Huber, Luka Flegar
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