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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Liviu Segall, Ionuţ Nistor, Julio Pascual, Istvan Mucsi, Lluis Guirado, Robert Higgins, Steven Van Laecke, Rainer Oberbauer, Wim Van Biesen, Daniel Abramowicz, Cristina Gavrilovici, Ken Farrington, Adrian Covic
During the last 20 years, waiting lists for renal transplantation (RT) have grown significantly older. However, elderly patients (ie ≥65 years of age) are still more rarely referred or accepted to waiting lists and, if enlisted, have less chances of actually receiving a kidney allograft, than younger counterparts. In this review, we looked at evidence for the benefits and risks of RT in the elderly trying to answer the following questions: Should RT be advocated for elderly patients? What should be the criteria to accept elderly patients on the waiting list for RT? What strategies might be used to increase the rate of RT in waitlisted elderly candidates? For selected elderly patients, RT was shown to be superior to dialysis in terms of patient survival...
October 2016: Transplantation
Hessel Peters-Sengers, Stefan P Berger, Martin B A Heemskerk, Doaa Al Arashi, Jaap J Homan van der Heide, Aline C Hemke, Ineke J M Ten Berge, Mirza M Idu, Michiel G H Betjes, Arjan D van Zuilen, Luuk B Hilbrands, Aiko P J de Vries, Azam S Nurmohamed, Maarten H Christiaans, L W Ernest van Heurn, Johan W de Fijter, Frederike J Bemelman
An increasing number of elderly patients (≥65 years) receive a donor kidney from elderly donors after brain death (DBD) or after circulatory death (DCD). These organs are allocated within the Eurotransplant Senior Program, but outcomes must be evaluated. From the Dutch Organ Transplantation Registry, we selected 3597 recipients (≥18 years) who received a first DBD or DCD kidney during 2002-2012, and categorized them as young or elderly recipients receiving a graft from either a young or elderly donor, stratified by donor type...
October 11, 2016: Journal of the American Society of Nephrology: JASN
Raymond L Heilman, Amit Mathur, Maxwell L Smith, Bruce Kaplan, Kunam S Reddy
This review will concentrate on the literature regarding donor kidneys that are currently being utilized at a relatively low rate. Donors with AKI seem to have outcomes equivalent to those without AKI provided one can rule out significant cortical necrosis. Donors with pre-existing diabetes or hypertension may have a marginally lower aggregate survival, but still provide a significant benefit over remaining on the wait list. As KDPI only derives an aggregate association with survival with a very modest C statistic, the data would indicate that this should not be the sole reason to discard a kidney except perhaps in patients with extremely low EPTS scores...
May 12, 2016: American Journal of Transplantation
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