Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly.

Autor: Serrano OK; Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Yadav K; Hume-Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USA., Bangdiwala A; Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA., Vock DM; Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA., Dunn TB; Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Finger EB; Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Pruett TL; Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Matas AJ; Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Kandaswamy R; Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2018 Aug; Vol. 32 (8), pp. e13287. Date of Electronic Publication: 2018 Jun 20.
DOI: 10.1111/ctr.13287
Abstrakt: 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/1.73 m 2 ; P < .001). Intraoperative and postoperative complications were similar, except a higher prevalence of <30 day ileus (3% vs 7%; P = .021) and longer postoperative length of stay (LOS) (4.2 vs 4.6 days; P = .005). On multivariate analysis, <30 day ileus and LOS continued to be significantly greater for >60-years-old After >20 years post-DN, systolic blood pressure was significantly higher among >60-years-old (142 vs 125 mm Hg; P < .001) and HTN was diagnosed earlier (9 vs 14 years). After donation, eGFR was significantly lower for >60-years-old but slope of eGFR and rates of end-stage renal disease (ESRD) were not significantly different >20 years post-DN. Thus, kidney donation among carefully selected >60-years-old poses minimal perioperative risks and no added risk of long-term ESRD.
(© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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