Renal Transplant From Very Old Donors: How Far Can We Go?

Collini, Andrea; Kalmár, P.; Dhamo, Armando; Ruggieri, Giuliana; Carmellini, Mario

doi:10.1097/tp.0b013e3181a6b4ff

Cited by 40 publications

(25 citation statements)

References 30 publications

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“…For example, Chavalitdhamrong and associates 7 found that transplants from donors aged 70 years and older were associated with a higher risk of graft loss and patient death compared with transplants from donors aged 60 to 69 years. However, Collini and associates 8 reported their experiences at an Italian transplant center where they used "ultra-old"donors (> 75 years old) with increasing graft survival rates.…”

Section: Discussionmentioning

confidence: 99%

Long-term Results of Renal Transplant From Living Donors Aged Over 60 Years

Lan¹,

Yang²,

Longkai³

et al. 2012

Exp Clin Transplant

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Objectives: This study sought to determine whether recipients of grafts from donors aged 60 years or older achieve the same benefit as those from younger donors in the long term. Materials and Methods: Between January 2004 and July 2008, one hundred seventeen living renal transplants were performed. The patients were divided into an older donor group (aged ≥ 60 y, n=23) and a younger donor group (aged < 60 y, n=94). Characteristics and evolution of the donors and recipients were compared between the groups. Results: There was no statistically significant difference between the groups respecting sex, body mass index, duration on dialysis, ischemia time, human leukocyte antigen matches and incidence of primary nonfunction, delayed graft function, acute rejection, and infection (P > .05). The 1-, 3-, and 5-year graft survival for the older group versus the younger group was 95.7% versus 97.9% (P > .05), 91.3% versus 93.6% (P > .05), and 81.8% versus 83.3% (P > .05). Patient survival at 1, 3, and 5 years was 100% versus 100% (P > .05), 95.7% versus 96.8% (P > .05), and 90.9% versus 88.9% (P > .05) with no significant difference in the log-rank test for KaplanMeier. Conclusions: Our studies suggest that in the long term, renal transplant from live donors older than 60 years it is an acceptable alternative.

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Section: Discussionmentioning

confidence: 99%

Long-term Results of Renal Transplant From Living Donors Aged Over 60 Years

Lan¹,

Yang²,

Longkai³

et al. 2012

Exp Clin Transplant

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“…When stratified by recipient age, ECD kidneys from donors aged 70 years (compared to ECD 50-69 years) were associated with an increased risk of DCGF for recipients aged 41-60 years (HR 1.48, 95%CI 1.06, 2.06; p=0.02) but not for older recipients aged >60 years (HR 1.12, 95%CI 0.86, 1.46; p=0.40), suggesting that older ECD kidneys may have a smaller unfavourable impact in older recipients. In contrast, an Italian study demonstrated that 3-year graft and patient survival was similar in recipients receiving ECD kidneys from donors >75 years and <75 years (Collini, Kalmar et al 2009). This inconsistent finding may be explained by the greater use of double kidneys (from donors >75 years) in the Italian study.…”

Section: Expanded-criteria Donor (Ecd) Kidneys (mentioning

confidence: 99%

The Impact of Donor Type and Quality on Renal Transplant Outcomes

Nguyen¹,

Yong²,

Croke³

et al. 2011

Understanding the Complexities of Kidney Transplantation

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“…El principal y el primer problema con el que nos encontramos es que en la definició n de los criterios ampliados de donació n, el límite inferior de edad está claramente definido (60-65 añ os), pero no sucede lo mismo con el superior. Por lo tanto, debemos preguntarnos cuá l es la edad má xima aceptable para un donante cadá ver 5 . Un 30-40% de los )riñ ones de ECD* que en un principio se consideran aptos se termina por rechazar, sobre todo una vez valorados en la cirugía de banco y biopsiados 4 .…”

Section: Discusió Nunclassified

Edad del donante y su influencia en la supervivencia del injerto

Abad

Eizaguirre

Mayans

et al. 2010

Actas Urológicas Españolas

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Objetivo: Nuestro objetivo es analizar la influencia de la edad del donante en la supervivencia del injerto. Para el estudio de la supervivencia actuarial del injerto se ha utilizado el mé todo de Kaplan Meyer. Para la comparació n de curvas de supervivencia utilizamos el test de logrank. Para el estudio de los factores influyentes en la supervivencia hemos utilizado los modelos de regresió n de Cox en forma de estudio univariado y multivariado.Resultados: La media de seguimiento fue de 48 meses (733,4 DE) y la mediana de seguimiento fue de 48 meses (rango de 0-166 meses).El aná lisis univariado de la supervivencia del injerto nos mostró que la edad del donante como variable continua influye significativamente en la supervivencia del injerto (odds ratio: 1,03; 95% intervalo de confianza [IC]: 1,01-1,05; p ¼0,009).Al estudiar la relació n entre la edad del donante y el receptor evidenciamos una correlació n inversa significativa (correlació n de Pearson: 0,55; po0,0001), pero a pesar de esto, la significació n se mantiene si se ajusta con la edad de los receptores (odds ratio: 1,02; 95% IC: 1,01-1,04) (p ¼0,04). El mejor punto de corte corresponde a 60 añ os.La supervivencia actuarial del injerto en donantes mayores de 60 añ os es del 79 (95% IC: 74-84) y del 71% (95% IC: 65-77) en 3 y 5 añ os frente al 94 (95% IC: 94-96%) y al 90% (95% IC: 88-92) en los receptores de riñ ones de donantes menores de 60 añ os (p ¼0,002).El estudio multivariado de los factores influyentes en la supervivencia del injerto revela que la edad del donante dicotomizada en mayor y menor de 60 añ os, la presencia de reintervenciones quirú rgicas inmediatas y la funció n diferida eran los factores de influencia independiente en la supervivencia del injerto.Conclusiones: La edad del donante mayor de 60 añ os influye negativamente en la supervivencia del injerto renal con valor pronó stico independiente.

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Renal Transplant From Very Old Donors: How Far Can We Go?

Cited by 40 publications

References 30 publications

Long-term Results of Renal Transplant From Living Donors Aged Over 60 Years

Long-term Results of Renal Transplant From Living Donors Aged Over 60 Years

The Impact of Donor Type and Quality on Renal Transplant Outcomes

Edad del donante y su influencia en la supervivencia del injerto

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