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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
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 2002-2015 were included. Donor and recipient age were categorized as <40, 40-59 and ≥60 years...
June 29, 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 using the Scientific Registry of Transplant Recipients. Donor quality and candidate condition were measured using Kidney Donor Profile Index (KDPI) and Estimate Post-Transplant Survival (EPTS)...
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...
June 20, 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) age≥70 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 with age>45, BMI<35, indication other than hepatitis C, and cold ischemia time<8 hours. METHODS: We assessed the validity of the preferred recipient construct in a larger, more recent cohort (38,891 patients, 2006-2013)...
March 22, 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
E Ferreira, J Costa, C Romãozinho, L Santos, F Macário, C Bastos, R Alves, A Figueiredo
BACKGROUND: Organ shortage has prompted the use of expanded-criteria donors (ECDs). Our objective was to compare long-term outcomes of kidney transplants from ECDs with those from concurrent standard-criteria donors (SCDs). In addition, we evaluated variables associated with graft survival in both groups. METHODS: We retrospectively reviewed all 617 deceased-donor kidney transplantations performed from 2005 to 2009 in our department. The population was divided according to donor status into ECD or SCD...
May 2017: Transplantation Proceedings
Ana Sánchez-Escuredo, Amaia Sagasta, Ignacio Revuelta, Lida M Rodas, David Paredes, Mireia Musquera, Fritz Diekmann, Josep M Campistol, Manel Solé, Federico Oppenheimer
There is no consensus on the allocation of renal transplants from expanded criteria donors (ECD). The Kidney Donor Profile Index (KDPI) is used without the need for pretransplant donor biopsies (PTDB). We explored whether PTDB based on Remuzzi Score (RS) allows identification of those marginal kidneys in the highest calculated KDPI risk group (>91%) that appropriate for single transplantation. A retrospective study was conducted of 485 consecutive kidneys procured from a single center and transplanted if the RS was ≤4...
October 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
H Jun, C W Jung, S Lim, M G Kim
BACKGROUND: The Kidney Donor Risk Index (KDRI) scoring system for deceased donors has been widely introduced for postoperative evaluation of graft function. We analyzed the usefulness of the KDRI in deceased donors with acute kidney injury (AKI). METHODS: Forty-nine recipients from deceased donors with AKI between January 2009 and December 2014 were reviewed retrospectively. Data collected from donor medical records included age, height, weight, hypertension or diabetes history, cause of death, serum creatinine (sCr), and donation after cardiac death...
January 2017: Transplantation Proceedings
María José Pérez-Sáez, Núria Montero, Dolores Redondo-Pachón, Marta Crespo, Julio Pascual
The old-for-old allocation policy used for kidney transplantation (KT) has confirmed the survival benefit compared to remaining listed on dialysis. Shortage of standard donors has stimulated the development of strategies aimed to expand acceptance criteria, particularly of kidneys from elderly donors. We have systematically reviewed the literature on those different strategies. In addition to the review of outcomes of expanded criteria donor or advanced age kidneys, we assessed the value of the Kidney Donor Profile Index policy, preimplantation biopsy, dual KT, machine perfusion and special immunosuppressive protocols...
April 2017: Transplantation
Abhishek Ravinuthala, Xiaonan Mei, Michael Daily, Malay Shah, Analia Castellanos, Jonathan Berger, Roberto Gedaly
BACKGROUND: We aimed to study outcomes on octogenarian patients undergoing kidney transplantation in the US. METHODS: We queried the UNOS dataset from 1988 through 2013 and found 471 octogenarians transplanted during the study period. RESULTS: 86 (18.3%) were female and 385 (81.7%) were male with a mean age of 81.58 years. The octogenarians had a significantly higher incidence of diabetes, at 17.2% compared to 13.7% in the non-octogenarian group (p < 0...
February 2017: Clinical Nephrology
2016-12-21 13:21:21
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