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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Maria Pippias, Kitty J Jager, Anders Åsberg, Stefan P Berger, Patrik Finne, James G Heaf, Julia Kerschbaum, Marko Lempinen, Ángela Magaz, Ziad A Massy, Vianda S Stel
Background: Updated survival outcomes of young recipients receiving young or old deceased donor kidneys are required when considering accepting a deceased donor kidney. Methods: We examined outcomes in 6448 European kidney allografts donated from younger (≥20-<50 years) and older (≥50-<70 years) deceased donors when transplanted into very young (≥20-<35 years) or young (≥35-<50 years) adult recipients. Outcomes of first kidney transplantations during 2000-13 and followed-up to 2015 were determined via competing risk, restricted mean survival and Cox regression methods...
September 7, 2018: Nephrology, Dialysis, Transplantation
Camille Legeai, Roland M Andrianasolo, Olivier Moranne, Renaud Snanoudj, Maryvonne Hourmant, Marc Bauwens, Joaquim Soares, Christian Jacquelinet, Cécile Couchoud, Marie-Alice Macher
Our objectives were to evaluate kidney transplantation survival benefit in people aged ≥70 who were receiving renal replacement therapy (RRT) and to identify their risk factors for posttransplant mortality. This study included all patients in the national French Renal Epidemiology and Information Network registry who started RRT between 2002 and 2013 at age ≥70. Mortality risk was compared between patients with transplants; on the waiting list; and on dialysis matched for age, gender, comorbidities, and time on dialysis...
November 2018: American Journal of Transplantation
Giacomo Colussi, Costanza Casati, Valeriana Giuseppina Colombo, Mario Livio Pietro Camozzi, Fabio Rosario Salerno
AIM: To compare survival of kidney transplants from deceased extended criteria donors (ECD) according to: (1) donor graft histological score; and (2) allocation of high score grafts either to single (SKT) or dual (DKT) transplant. METHODS: Renal biopsy was performed as part of either a newly adopted DKT protocol, or of surveillance protocol in the past. A total 185 ECD graft recipients were categorized according to pre-implantation graft biopsy into 3 groups: SKT with graft score 1 to 4 [SKT(1-4) , n = 102]; SKT with donor graft score 5 to 8 [SKT(> 4) , n = 30]; DKT with donor graft score 5 to 7 (DKT, n = 53)...
August 9, 2018: World Journal of Transplantation
M Magott-Procelewska, K Madziarska, M Boratynska, P Chudoba, A Lepiesza, O Mazanowska, S Zmonarski, M Madziarski, K Hap, M Klinger
BACKGROUND: The long-term burden of higher donor age on graft function and survival after kidney transplantation remains uncertain. Because both recipient and donor characteristics have evolved and the general population age is on the increase, we looked at the causes of kidney graft outcome. AIM: The aim of this study was to evaluate the impact of different clinical parameters on long-term outcome of older-donor kidney transplantation. This retrospective study included 345 adult patients (58 patients received kidney from donors at least 55 years old) transplanted between January 1993 and December 2005 and were followed in one center throughout the post-transplant course (median, 9...
July 2018: Transplantation Proceedings
Mathieu Lesouhaitier, Camille Legeai, Emilie Savoye, Christelle Cantrelle, Isabelle Pipien, Marie-Alice Macher, Cécile Vigneau, Richard Dorent
Coronary angiography (CA) is the gold standard evaluation of coronary artery disease in potential multi-organ donors. This use of iodinated contrast media could lead to contrast-induced acute kidney injury and consequently to delayed graft function (DGF). All patients in France who received a kidney from a 45-70-year-old donor without medical contraindication for cardiac donation and with at least one cardiovascular risk factor were included. Recipients of preemptive kidney transplant or multi-organ transplant, or who died within the first 8 days post-transplantation were excluded...
July 19, 2018: Clinical Transplantation
Sheng Zhou, Allan B Massie, Courtenay M Holscher, Madeleine M Waldram, Tanveen Ishaque, Alvin G Thomas, Dorry L Segev
BACKGROUND: Many kidneys are discarded every year, with 3631 kidneys discarded in 2016 alone. Identifying kidneys at high risk of discard could facilitate 'rescue' allocation to centers more likely to transplant them. The Probability of Delay or Discard (PODD) model was developed to identify marginal kidneys at risk of discard or delayed allocation beyond 36 hours of cold ischemia time. However, PODD has not been prospectively validated, and patterns of discard may have changed following policy changes such as the introduction of Kidney Donor Profile Index and implementation of the Kidney Allocation System (KAS)...
July 13, 2018: Transplantation
Therese Bittermann, David S Goldberg
BACKGROUND: Increasing recipient and donor age are independently associated with survival after liver transplantation (LT). Whether donor age differentially impacts post-LT outcomes based on recipient age is unknown. METHODS: This was a retrospective cohort study using Organ Procurement and Transplantation Network data. All adult deceased-donor, single organ, primary LTs from 2002 to 2015 were included. Donor and recipient age were categorized as younger than 40 years, 40 to 59 years, and 60 years or older...
December 2018: Transplantation
Sandra K Kabagambe, Ivonne P Palma, Yulia Smolin, Tristan Boyer, Ivania Palma, Junichiro Sageshima, Christoph Troppmann, Chandrasekar Santhanakrishnan, John P McVicar, Kuang-Yu Jen, Miriam Nuño, Richard V Perez
BACKGROUND: Despite careful clinical examination, procurement biopsy and assessment on hypothermic machine perfusion (HMP), a significant number of potentially useable deceased donor kidneys will be discarded because they are deemed unsuitable for transplantation. Ex vivo normothermic perfusion (EVNP) may be useful as a means to further assess high-risk kidneys to determine suitability for transplantation. METHODS: From June 2014 to October 2015, 7 kidneys (mean donor age 54...
June 27, 2018: Transplantation
Sunjae Bae, Allan B Massie, Alvin G Thomas, Gahyun Bahn, Xun Luo, Kyle R Jackson, Shane E Ottmann, Daniel C Brennan, Niraj M Desai, Josef Coresh, Dorry L Segev, Jacqueline M Garonzik Wang
The impact of donor quality on post-kidney transplant (KT) survival may vary by candidate condition. Characterizing this variation would increase access to KT without sacrificing outcomes. We developed a tool to estimate post-KT survival for combinations of donor quality and candidate condition. We studied deceased donor KT recipients (n = 120 818) and waitlisted candidates (n = 376 272) between 2005 and 2016 by using the Scientific Registry of Transplant Recipients. Donor quality and candidate condition were measured by using the Kidney Donor Profile Index (KDPI) and the Estimated Post Transplant Survival (EPTS) score...
June 23, 2018: American Journal of Transplantation
Oscar K Serrano, Kunal Yadav, Ananta Bangdiwala, David M Vock, Ty B Dunn, Erik B Finger, Timothy L Pruett, Arthur J Matas, Raja Kandaswamy
With increasing organ demand, living kidney donation from older donors (>60-years-old) has become more common. Between 1975 and 2014, 3752 donor nephrectomies (DN) were performed at University of Minnesota; 167 (4.5%) were >60-years-old Short- and long-term outcomes were compared between contemporaneous >60-years-old and <60-years-old donors. On univariate analysis, >60-years-old were more likely to have had prior abdominal surgery and hypertension; and less likely to smoke. Baseline estimated glomerular filtration rate (eGFR) was lower in >60-years-old (80 ± 16 vs 101 ± 26 mL/min/1...
August 2018: Clinical Transplantation
Costanza Casati, Valeriana Giuseppina Colombo, Marialuisa Perrino, Ornella Marina Rossetti, Marialuisa Querques, Alessandro Giacomoni, Agnese Binaggia, Giacomo Colussi
Background: Grafts from elderly donors (ECD) are increasingly allocated to single (SKT) or dual (DKT) kidney transplantation according to biopsy score. Indications and benefits of either procedure lack universal agreement. Methods: A total of 302 ECD-transplants in period from Jan 1, 2000, to Dec 31, 2015, were allocated to SKT (SKTpre ) on clinical grounds alone (before Dec 2010, pre-DKT era, n = 170) or according to a clinical-histological protocol (after Dec 2010, DKT era, n = 132) to DKT ( n = 48), SKT biopsy-based protocol ("high-risk", SKThr , n = 51), or SKT clinically based protocol ("low-risk", SKTlr , n = 33)...
2018: Journal of Transplantation
Thomas Fehr
No abstract text is available yet for this article.
July 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Christine E Haugen, Alvin G Thomas, Jacqueline Garonzik-Wang, Allan B Massie, Dorry L Segev
BACKGROUND: Allografts from older liver donors (OLDs), 70 years or older are often discarded for fear of inferior outcomes. We previously identified "preferred recipients" who did not suffer the higher risk of graft loss and mortality associated with OLDs. Preferred recipients were first-time, non-status 1 registrants older than 45 years, body mass index less than 35, indication other than hepatitis C, and cold ischemia time less than 8 hours. METHODS: We assessed the validity of the preferred recipient construct in a larger, more recent cohort (38 891 patients, 2006-2013)...
September 2018: Transplantation
Michael J Englesbe
No abstract text is available yet for this article.
May 2018: American Journal of Transplantation
Daniel R Kaul
No abstract text is available yet for this article.
March 2018: American Journal of Transplantation
A H Querard, F Le Borgne, A Dion, M Giral, G Mourad, V Garrigue, L Rostaing, N Kamar, A Loupy, C Legendre, E Morelon, F Buron, Y Foucher, E Dantan
From a prospective and multicentric French cohort, we proposed an external validation study for the expanded criteria donor (ECD), based on 4833 kidney recipients transplanted for the first time between 2000 and 2014. We estimated the subject-specific effect from a multivariable Cox model. We confirmed a 1.75-fold (95% confidence interval [CI] 1.53-2.00, P < .0001) increase in graft failure risk if a given patient received an ECD graft compared to a graft from a donor with standard criteria (standard criteria donor [SCD])...
May 2018: American Journal of Transplantation
Piero Ruggenenti, Cristina Silvestre, Luigino Boschiero, Giovanni Rota, Lucrezia Furian, Annalisa Perna, Giuseppe Rossini, Giuseppe Remuzzi, Paolo Rigotti
To assess whether biopsy-guided selection of kidneys from very old brain-dead donors enables more successful transplantations, the authors of this multicenter, observational study compared graft survival between 37 recipients of 1 or 2 histologically evaluated kidneys from donors older than 80 years and 198 reference-recipients of non-histologically evaluated single grafts from donors aged 60 years and younger (transplantation period: 2006-2013 at 3 Italian centers). During a median (interquartile range) of 25 (13-42) months, 2 recipients (5...
December 2017: American Journal of Transplantation
Flavia Neri, Lucrezia Furian, Francesco Cavallin, Matteo Ravaioli, Cristina Silvestre, Paola Donato, Gaetano La Manna, Antonio Daniele Pinna, Paolo Rigotti
The aging of the on-dialysis population raises the issue of whether to propose elderly patients for kidney transplantation and how to manage their immunosuppression. This study aimed to analyze the outcome of kidney transplantation on an Italian series of elderly recipients. We included in this retrospective study all patients over 60 years, receiving a deceased-donor kidney transplantation from January 2004 to December 2014 in two north Italian Centers. We analyzed the correlation of recipient age with graft's and patient's survival, delayed graft function, acute cellular rejection (ACR), surgical complications, infections, and glomerular filtration rate...
October 2017: Clinical Transplantation
K Ko, Y H Kim, M H Kim, K W Jun, J K Hwang, S D Kim, S C Park, J I Kim, I S Moon
PURPOSE: Our objective was to investigate the effects of age on patient and graft survival in expanded criteria donor (ECD) renal transplantation. METHODS: Between February 2000 and December 2015, we analyzed 405 deceased donor renal transplants, including 128 grafts (31.9%) from ECDs. Based on recipient age and ECD criteria classification, the recipients were divided into four groups: Group I, non-ECD to recipient age <50 years; Group II, non-ECD to recipient age ≥50 years; Group III, ECD to recipient age <50 years; and Group IV, ECD to recipient age ≥50 years...
June 2017: Transplantation Proceedings
Giovanni Stallone, Giuseppe Grandaliano
No abstract text is available yet for this article.
October 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
2017-05-12 06:18:11
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