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 0 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.