The "oldest and coldest" shipped living donor kidneys transplanted through kidney paired donation.

Autor: Nassiri N; Institute of Urology, University of Southern California, Los Angeles, California., Kwan L; Department of Urology, University of California Los Angeles, Los Angeles, California., Bolagani A; Department of Urology, University of California Los Angeles, Los Angeles, California., Thomas AG; Department of Surgery, Johns Hopkins University, Baltimore, Maryland.; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina., Sinacore J; National Kidney Registry, Babylon, New York., Ronin M; National Kidney Registry, Babylon, New York., Cooper M; Medstar Georgetown Transplant Institute, Washington, District of Columbia., Segev DL; Department of Surgery, Johns Hopkins University, Baltimore, Maryland., Cecka JM; Immunogenetics Center, University of California Los Angeles, Los Angeles, California., Veale JL; Department of Urology, University of California Los Angeles, Los Angeles, California.
Jazyk: angličtina
Zdroj: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2020 Jan; Vol. 20 (1), pp. 137-144. Date of Electronic Publication: 2019 Aug 20.
DOI: 10.1111/ajt.15527
Abstrakt: To date, thousands of living donor kidneys have been shipped through kidney paired donation (KPD). To expand on this growing segment of living donor transplantation, we evaluated the effect of advanced age donation ("oldest kidneys") and prolonged cold ischemia time ("coldest kidneys") on graft function and survival using the National Kidney Registry database from February 2008 to May 2018. Donors were stratified by age at time of donation (<65 or ≥65 years) and kidneys were stratified by cold ischemia time (<16 or ≥16 hours). We evaluated delayed graft function and death-censored graft failure (DCGF) for up to seven posttransplant years. Of the 2363 shipped living donor kidney transplants, 4.1% of donors were ≥65 years and 6.0% of transplanted kidneys had cold ischemia times ≥16 hours. Delayed graft function and DCGF occurred in 5.2% and 4.7% of cases. There were no significant associations between delayed graft function and donor age (P = .947) or cold ischemia (P = .532). Donor age and cold ischemia time were not predictive of delayed graft function (OR = 0.86,1.20; P = .8, .6) or DCGF (HR = 1.38,0.35, P = .5, .1). These findings may alleviate concerns surrounding the utilization of kidneys from older donors or those originating from distant transplant centers.
(© 2019 The American Society of Transplantation and the American Society of Transplant Surgeons.)
Databáze: MEDLINE
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