An alternative approach to estimate age-related mortality of kidney transplant recipients compared to the general population: results in favor of old-to-old transplantations

Foucher, Yohann; Akl, Ahmed; Rousseau, Vanessa; Trébern-Launay, Katy; Lorent, Marine; Kessler, Michèle; Ladrière, Marc; Legendre, Christophe; Kreis, Henri; Rostaing, Lionel; Kamar, Nassim; Mourad, Georges; Garrigue, Valérie; Morélon, Emmanuel; Buron, Fanny; Daurès, Jean‐Pierre; Soulillou, Jean‐Paul; Giral, Magali

doi:10.1111/tri.12241

Cited by 14 publications

(16 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We cannot determine the underlying reasons for this, because the cause of allograft failure is unavailable in the Korea Organ Transplantation Registry. Possible reasons might include the significantly lower impact of donor quality in the elderly; for example, elderly donors on post‐transplant allograft outcome . Furthermore, the distribution of confounding variables also varies between LDKT and DDKT.…”

Section: Discussionmentioning

confidence: 99%

“…Possible reasons might include the significantly lower impact of donor quality in the elderly; for example, elderly donors on posttransplant allograft outcome. 24,25 Furthermore, the distribution of confounding variables also varies between LDKT and DDKT. For example, the pre-transplant dialysis duration was shorter in elderly-DDKT than young-DDKT, which was not observed between elderly-LDKT and young-LDKT.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical outcomes of kidney transplantation in older end‐stage renal disease patients: A nationwide cohort study

Yang

Ahn

et al. 2019

Geriatrics Gerontology Int

View full text Add to dashboard Cite

Aim The aim of the present study was to investigate the clinical outcomes of kidney transplantation (KT) in elderly recipients compared with those in young recipients. Methods We compared the incidence of biopsy‐proven acute rejection, death‐censored allograft survival and all‐cause mortality, and also compared the impact of high sensitization or desensitization on the clinical outcomes of elderly and young recipients. Results A total of 4966 KT recipients from the Korean Organ Transplantation Registry were included. The definition of elderly recipients was based on age >60 years (n = 356), and recipients aged <60 years were defined as young recipients (n = 4610). The incidence of biopsy‐proven acute rejection did not differ between the two groups irrespective of the donor type; however, the impact of high sensitization was significant only in young recipients. Being an elderly recipient was an independent risk factor for death‐censored allograft failure in terms of overall and living donor KT, but not with deceased donor KT. In regard to patient death, being an elderly recipient was a significant predictor in general and in the two subgroups, and desensitization showed a significant interaction with death in the elderly recipients in the living donor KT group. Conclusions In conclusion, KT in elderly recipients might be associated with poor allograft or patient survival in general, and especially, desensitization therapy carried out in these patients might increase the risk of patient mortality. Geriatr Gerontol Int 2019; 19: 392–398.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of kidney transplantation in older end‐stage renal disease patients: A nationwide cohort study

Yang

Ahn

et al. 2019

Geriatrics Gerontology Int

View full text Add to dashboard Cite

show abstract

“…These were cardiovascular disease, peripheral vascular disease (PVD), history of diabetes, hepatitis C virus infection, human immunodeficiency virus (HIV) positivity, the recipient risk score, and multiple separate comorbidities. [16][17][18][19][20][21][22][23] In all studies, the presence of an increasing burden of comorbidity predicted a lower patient survival. However, the highest comorbidity score was not necessarily the same in all studies as acceptance criteria and definitions of comorbidity were adapted to current knowledge and experience.…”

mentioning

confidence: 99%

A High Comorbidity Score Should Not be a Contraindication for Kidney Transplantation

Laging

Gestel²,

Wetering³

et al. 2016

Transplantation

View full text Add to dashboard Cite

show abstract

“…Also noteworthy is that during the last decade, the rate of pancreas transplantation has declined by 20% in the U.S., probably due to a decline in organ donor quality (10). Despite the advances, KT recipients die prematurely most commonly due to cardiovascular disease, infections, or malignancy (11,12).…”

mentioning

confidence: 99%

Long-term Mortality After Kidney Transplantation in a Nationwide Cohort of Patients With Type 1 Diabetes in Finland

et al. 2018

View full text Add to dashboard Cite

OBJECTIVETo examine time trends in mortality rates and causes of death in patients with type 1 diabetes and end-stage renal disease on dialysis and after kidney transplantation. RESEARCH DESIGN AND METHODSIn a nationwide retrospective cohort analysis, all patients with type 1 diabetes in Finland who received a kidney transplant alone were compared with patients who remained on dialysis. The main outcome was patient survival after starting dialysis. The cohort was divided into dialysis, functioning kidney transplant, and dialysis after transplant loss. Causes of death were retrieved and standardized mortality ratios calculated. RESULTSWe studied 2,383 patients. Patients survived a median of 15.9 years after a successful transplant, 11.2 years if transplant function was lost, and 2.9 years if they remained on chronic dialysis. Standardized mortality ratio decreased in all subgroups during the past four decades: from 2005 onwards, it was 3.9 in patients receiving a kidney transplant, 11.5 in patients with graft loss, and 32.5 in patients on dialysis. The most common cause of death in all patients was ischemic heart disease (45%) followed by infection (18%), which was more common in patients on dialysis. CONCLUSIONSKidney transplantation is the treatment of choice for patients with type 1 diabetes and end-stage renal disease because it substantially reduces the excess death risk when compared with dialysis. Even when kidney graft function is lost, the excess death risk is still considerably lower. Although overall mortality has decreased over the years, premature death due to ischemic heart disease remains high.Type 1 diabetes (T1D), a common disease in children and young adults, is associated with high risk of both acute and chronic complications. Diabetic nephropathy is a severe complication in patients with T1D, and in Finland, recent data show that 7.0% of the patients progress to end-stage renal disease (ESRD) after 30 years of T1D (1), whereas in the U.S., 25% have been shown to progress to ESRD after 40 years of T1D (2). Moreover, registry data show that between 4 and 17% of patients starting renal replacement treatment (RRT) have T1D (3,4). It is well known that patients with ESRD carry a manifold increased risk of premature mortality when compared with the general population, and this is particularly true for patients with T1D (5,6).

show abstract

An alternative approach to estimate age-related mortality of kidney transplant recipients compared to the general population: results in favor of old-to-old transplantations

Cited by 14 publications

References 27 publications

Clinical outcomes of kidney transplantation in older end‐stage renal disease patients: A nationwide cohort study

Clinical outcomes of kidney transplantation in older end‐stage renal disease patients: A nationwide cohort study

A High Comorbidity Score Should Not be a Contraindication for Kidney Transplantation

Long-term Mortality After Kidney Transplantation in a Nationwide Cohort of Patients With Type 1 Diabetes in Finland

Contact Info

Product

Resources

About