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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28792681/long-term-outcome-of-renal-transplantation-from-octogenarian-donors-a-multicenter-controlled-study
#1
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...
August 9, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28640530/how-does-age-affect-the-outcome-of-kidney-transplantation-in-elderly-recipients
#2
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...
June 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28583572/effect-of-donor-recipient-age-match-in-expanded-criteria-deceased-donor-kidney-transplantation
#3
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
https://www.readbyqxmd.com/read/28493629/it-is-the-time-to-rethink-the-criteria-to-define-transplantable-kidneys-should-we-combine-histological-and-clinical-evaluation
#4
Giovanni Stallone, Giuseppe Grandaliano
In this issue of Transplantation International, Sanchez-Escudero et al [1] report the results obtained from a prospective single centre study enrolling 485 consecutive transplant recipients receiving a kidney with a Remuzzi score (RS) [2] of Pre Transplant Donor Biopsies (PTDB) lower or equal to 4. Then retrospectively, the authors compared their organ allocation policy based on RS with kidney donor profile index (KDPI) [3] and evaluated the discard rate between KDPI and PTDB and five years graft and patients survival...
May 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28457392/long-term-outcomes-of-kidney-transplantation-from-expanded-criteria-deceased-donors-a-single-center-experience
#5
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
https://www.readbyqxmd.com/read/28403541/histopathological-evaluation-of-pretransplant-donor-biopsies-in-expanded-criteria-donors-with-high-kidney-donor-profile-index-a-retrospective-observational-cohort-study
#6
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...
April 12, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28104166/kidney-donor-risk-index-as-the-predictor-for-the-short-term-clinical-outcomes-after-kidney-transplant-from-deceased-donor-with-acute-kidney-injury
#7
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
https://www.readbyqxmd.com/read/28072755/strategies-for-an-expanded-use-of-kidneys-from-elderly-donors
#8
REVIEW
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
https://www.readbyqxmd.com/read/27936521/perioperative-and-long-term-outcomes-in-octogenarians-after-kidney-transplantation-the%C3%A2-us-perspective%C3%A2
#9
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
https://www.readbyqxmd.com/read/27979990/dementia-and-alzheimer-s-disease-among-older-kidney-transplant-recipients
#10
Mara A McAdams-DeMarco, Sunjae Bae, Nadia Chu, Alden L Gross, Charles H Brown, Esther Oh, Paul Rosenberg, Karin J Neufeld, Ravi Varadhan, Marilyn Albert, Jeremy Walston, Dorry L Segev
Older patients with ESRD who receive a kidney transplant (KT) may develop post-KT dementia and Alzheimer's disease (AD) associated with their long-standing kidney disease and/or neurotoxic immunosuppressant agents. To investigate this possibility, we studied 40,918 older (aged ≥55 years) KT recipients (January 1, 1999 to December 31, 2011) linked to Medicare claims through the US Renal Data System. We estimated dementia and AD risk (cumulative incidence) and studied factors associated with these sequelae using competing risks models...
May 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27779800/the-expanded-criteria-donor-for-kidney-transplant-not-a-nearly-new-car
#11
Johan De Meester
No abstract text is available yet for this article.
January 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27472096/criteria-for-and-appropriateness-of-renal-transplantation-in-elderly-patients-with-end-stage-renal-disease-a-literature-review-and-position-statement-on-behalf-of-the-european-renal-association-european-dialysis-and-transplant-association-descartes-working
#12
REVIEW
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
https://www.readbyqxmd.com/read/27729570/stretching-the-limits-of-renal-transplantation-in-elderly-recipients-of-grafts-from-elderly-deceased-donors
#13
COMPARATIVE STUDY
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...
February 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27172238/increasing-the-utilization-of-kidneys-from-unconventional-and-higher-risk-deceased-donors
#14
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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