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Transpl Int. 2018 Jul;31(7):708-719. doi: 10.1111/tri.13103. Epub 2017 Dec 21.

Kidney transplant outcomes from older deceased donors: a paired kidney analysis by the European Renal Association-European Dialysis and Transplant Association Registry.

Author information

1
Department of Medical Informatics, ERA-EDTA Registry, Academic Medical Center, Universiteit van Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
2
UK Renal Registry, Southmead Hospital, Bristol, UK.
3
Population Health Sciences, University of Bristol, Bristol, UK.
4
Department of Transplantation Surgery, Karolinska University Hospital, Stockholm, Sweden.
5
Department of Nephrology, Helsinki University Central Hospital, Helsinki, Finland.
6
Finnish Registry for Kidney Diseases, Helsinki, Finland.
7
Department of Medicine, Roskilde Hospital, University of Copenhagen, Roskilde, Denmark.
8
Section for Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
9
Dutch Transplant Foundation, Leiden, the Netherlands.
10
Department of Nephrology, Radboud University Medical Centre, Nijmegen, the Netherlands.
11
Austrian Dialysis & Transplant Registry, Rohr, Austria.
12
Department of Transplantation and Liver Surgery, Helsinki University Hospital, Helsinki, Finland.
13
Unidad de Información sobre Pacientes Renales de la Comunidad Autónoma del País Vasco (UNIPAR), Basque Country, Spain.
14
Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
15
Statistics and Clinical Studies, NHS Blood and Transplant, Stoke Gifford, Bristol, UK.
16
Department of Nephrology, Hospital del Mar, Barcelona, Spain.
17
Swedish Renal Registry, Medicinexp, Jönköping, Sweden.
18
Department of Nephrology P, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
19
Scottish Renal Registry, ISD Scotland, Glasgow, Scotland.
20
Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, France.
21
Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Team 5, CESP UVSQ, University Paris Saclay, Villejuif, France.
22
Richard Bright Renal Unit, Southmead Hospital, Bristol, UK.

Abstract

As the median age of deceased kidney donors rises, updated knowledge of transplant outcomes from older deceased donors in differing donor-recipient age groups is required. Using ERA-EDTA Registry data we determined survival outcomes of kidney allografts donated from the same older deceased donor (55-70 years), and transplanted into one recipient younger and one recipient of similar age to the donor. The recipient pairs were divided into two groups: group 1; younger (median age: 52 years) and older (60 years) and group 2; younger (41 years) and older (60 years). A total of 1410 adults were transplanted during 2000-2007. Compared to the older recipients, the mean number of functioning graft years at 10 years was 6 months longer in the group 1 and group 2 younger recipients (P < 0.001). Ten-year graft survival was 54% and 40% for the group 1 younger and older recipients, and 60% and 49% for the group 2 younger and older recipients. Paired Cox regression analyses showed a lower risk of graft failure (group 1 younger; adjusted relative risk [RRa]:0.57, 95% CI:0.41-0.79, and group 2 younger; RRa:0.63, 95% CI:0.47-0.85) in younger recipients. Outcomes from older deceased donor allografts transplanted into differing donor-recipient age groups are better than previously reported. These allografts remain a valuable transplant resource, particularly for similar-aged recipients.

KEYWORDS:

deceased donors; donor age; graft survival; kidney transplant; registry

PMID:
29210108
DOI:
10.1111/tri.13103
[Indexed for MEDLINE]

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