Long-Term Patient and Graft Survival in the Eurotransplant Senior Program: A Single-Center Experience

Fabrizii, Veronika; Kovařík, Josef; Bodingbauer, Martin; Kramar, Reinhard; Hörl, Walter H.; Winkelmayer, Wolfgang C.

doi:10.1097/01.tp.0000168340.05714.99

Cited by 43 publications

(28 citation statements)

References 15 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since older individuals with comorbidities are more prone to infectious diseases, implementation of less-potent immunosuppressive regimens could be advocated. On the other hand, BPAR rates in our study cohort were quite high, but still compatible with reports by others [11,13,15]. However, graft loss due to chronic rejection was a rare event.…”

Section: Discussionsupporting

confidence: 79%

“…In particular, we wanted to extend previous analyses [11][12][13][14][15][16] by including outcome data that have so far not been studied in detail, including the risk of de-novo DSA development, BK viral infection rate, and tumor development.…”

Section: Discussionmentioning

confidence: 99%

“…In these studies, 1-and 5-year allograft survival rates in surviving patients ranged between 85-90% and 65-80%, while patient survival rates were slightly lower at 80-90% and 60-75%, respectively [6,[10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program (ESP): A Single-Center Experience from 2008 to 2013

et al. 2016

View full text Add to dashboard Cite

Background:The aim of this study was to evaluate the outcome after transplantation of deceased allografts in donor/recipient pairs aged ³65 years enrolled in the Eurotransplant Senior Program (ESP). Material/Methods:In this retrospective cohort study we evaluated data from 89 patients transplanted under the ESP protocol from 2008 to 2013. Outcome parameters included graft and patient survival, rate of biopsy-proven acute rejections (BPAR), peri-and post-operative complications, tumor development, development of donor-specific antibodies (DSA), and the prognostic role of preimplantation biopsies. Results:One-year patient and allograft survival rates were 92.1% and 84.3%, respectively. During follow-up, 23 (26%) patients died; the major cause of death was sepsis, followed by cardiovascular events and malignancies. BPAR episodes were frequent within the first year (~33%) and overall were less common in patients treated with tacrolimus. Post-transplant malignancies were seen in 15 (17%) patients. During follow-up, 16 (18%) patients developed DSA; patients with delayed graft function (DGF) were more likely to develop DSA (p=0.029). A higher preimplantation biopsy score was associated with DGF but did not predict later graft outcome. Conclusions:The results highlight increased risks in ESP transplant candidates and the importance of careful surveillance of this patient group.

show abstract

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program (ESP): A Single-Center Experience from 2008 to 2013

et al. 2016

View full text Add to dashboard Cite

show abstract

“…We found that the rate of DGF did not differ in our study group from control groups, and rate of DGF was in the range found by other authors. 5,[15][16][17] In addition, we did not find a negative impact of DGF on graft survival in the ESP recipients as described by others. 5,17 The favorable outcome in our study may be due to the very short CIT, because prolonged CIT is strongly associated with an increased rate of DGF.…”

supporting

confidence: 64%

Outcomes of Transplanting Deceased-Donor Kidneys between Elderly Donors and Recipients

Giessing

Fuller²,

Friedersdorff³

et al. 2009

Journal of the American Society of Nephrology

View full text Add to dashboard Cite

“…However, in the case of elderly patients the definition of a tailored immunosuppressive regimen is mandatory taking into account, as previously mentioned, the different immunological status along with the increased risk of infections and malignancy. The goal of immunosuppression should consist of a reduction of the risk of CNI nephrotoxicity along with a limited use of steroids because of the increased risk of infections, fractures, myopathy, and other steroid-related side effects [1,81,82].…”

Section: Strategy To Optimize the Outcome Of Marginal Donors And Kidnmentioning

confidence: 99%

Expanded Criteria Donors in Kidney Transplantation: The Role of Older Donors in a Setting of Older Recipients

Rosa

Muscogiuri

Sarno

2013

ISRN Transplantation

View full text Add to dashboard Cite

Kidney transplantation (KT) is the therapy of choice for end-stage renal disease (ESRD). The ESRD population is aging and so are patients waiting for KT. New strategies have been made for increasing the donor and recipient pools, and as a consequence kidneys from older donors or donors with significant comorbidities, the so-called "expanded criteria donor" (ECD) kidneys, are used for transplantation. Although good outcomes have been achieved from ECD, several issues are still waiting for clarification and need to be discussed. The concept of age matching is accepted as a method to ameliorate utilization of these allografts, but an optimal and widely accepted strategy is still not defined. The development of machine perfusion and the dual kidney transplantation are techniques which further improve the outcome of transplants from ECD, but the described experiences are scarce or coming from small single institutional reports. Also due to age-related immune dysfunction and associated comorbidities, the elderly recipients are more susceptible to immunosuppression related complications (e.g., infections and malignancy), although a widely accepted and validated immunosuppressive regimen is still lacking. In this paper, we review the issues related to KT employing allografts from marginal donors with a particular interest for the elderly patients.

show abstract

Long-Term Patient and Graft Survival in the Eurotransplant Senior Program: A Single-Center Experience

Abstract: Long-term patient and graft survival were comparable between elderly patients who received their organ via the ESP and the regular ETKAS algorithm.

Cited by 43 publications

References 15 publications

Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program (ESP): A Single-Center Experience from 2008 to 2013

Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program (ESP): A Single-Center Experience from 2008 to 2013

Outcomes of Transplanting Deceased-Donor Kidneys between Elderly Donors and Recipients

Expanded Criteria Donors in Kidney Transplantation: The Role of Older Donors in a Setting of Older Recipients

Contact Info

Product

Resources

About