Early outcomes of kidney transplantation from elderly donors after circulatory death (GEODAS study)
| Autor: | Pérez-Sáez, María José, Lafuente Covarrubias, Omar, Moreso, Francesc., Melilli, Edoardo, Juega-Marino, Javier, De Souza, Erika, López-Sánchez, Paula, Rodríguez-Ferrero, María Luisa, Maruri-Kareaga, Naroa, Navarro, María Dolores, Valero, Rosalía, Mazuecos, María Auxiliadora, Llamas, Francisco, Martín-Moreno, Paloma, Fernández-García, Antón, Espí, Jordi, Jiménez, Carlos, Ramos, Ana, Gavela, Eva, Pascual, Julio, Portolés, Jose M., Sánchez-Sobrino, Beatriz, Zapatero Ferrándiz, Ana, Hernández Marrero, Domingo, Manonelles, Anna, Lauzurica, Ricardo, Diekmann, Fritz, Zárraga, Sofía, Rodríguez-Benot, Alberto, Ruiz, Juan Carlos, Alonso Hernández, Ángel, Beneyto, Isabel, López-Oliva, María, Sancho-Calabuig, Asunción |
|---|---|
| Přispěvatelé: | UAM. Departamento de Medicina, Institut Català de la Salut, [Pérez-Sáez MJ] Departament de Nefrologia i programa de trasplantament renal, Hospital del Mar, Parc de Salut Mar, Universitat Autònoma Barcelona, Barcelona, Spain. Universitat Pompeu Fabra, Barcelona, Spain. Grup de recerca en nefropaties, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain. [Lafuente Covarrubias O] Nephrology & Transplant Department, University Hospital Puerta de Hierro, Madrid, Spain. Universidad Autónoma Madrid, Madrid, Spain. [Hernández D] Hospital Regional Universitario Carlos Haya, Malaga, Spain. [Moreso F] Hospital Universitari Vall d'Hebron, Barcelona, Spain. [Melilli E] Hospital Universitari de Bellvitge, Barcelona, Spain. [Juega J] Hospital Universitari Germans Trias i Pujol, Barcelona, Spain., Vall d'Hebron Barcelona Hospital Campus |
| Rok vydání: | 2019 |
| Předmět: |
Nephrology
Male Multivariate analysis Otros calificadores::Otros calificadores::/tendencias [Otros calificadores] España 030232 urology & nephrology Surgical Procedures Operative::Transplantation::Organ Transplantation::Surgical Procedures Operative::Kidney Transplantation [ANALYTICAL DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT] 030204 cardiovascular system & hematology lcsh:RC870-923 Persones grans Kidney transplantation chemistry.chemical_compound 0302 clinical medicine Clinical outcomes Registries personas::donantes de tejidos [DENOMINACIONES DE GRUPOS] Ronyons - Trasplantació Graft Survival Age Factors Shock Middle Aged Ciencias de la Salud::Medicina clínica [Materias Investigacion] Other subheadings::Other subheadings::/trends [Other subheadings] Tissue Donors Survival Rate Donants d'òrgans - Espanya Treatment Outcome Persons::Age Groups::Adult::Aged [NAMED GROUPS] Female Research Article medicine.medical_specialty Medicina Renal function Donor Selection 03 medical and health sciences Internal medicine medicine Humans Persons::Tissue Donors [NAMED GROUPS] personas::Grupos de Edad::adulto::anciano [DENOMINACIONES DE GRUPOS] Aged Creatinine Elderly donors Proportional hazards model business.industry Delayed graft function Donors after circulatory death medicine.disease lcsh:Diseases of the genitourinary system. Urology Comorbidity chemistry intervenciones quirúrgicas::trasplante::trasplante de órganos::intervenciones quirúrgicas::trasplante de riñón [TÉCNICAS Y EQUIPOS ANALÍTICOS DIAGNÓSTICOS Y TERAPÉUTICOS] Spain Observational study business |
| Zdroj: | BMC NEPHROLOGY r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) BMC Nephrology, Vol 20, Iss 1, Pp 1-8 (2019) Recercat. Dipósit de la Recerca de Catalunya instname Dadun. Depósito Académico Digital de la Universidad de Navarra BMC Nephrology Biblos-e Archivo. Repositorio Institucional de la UAM Scientia r-FISABIO. Repositorio Institucional de Producción Científica Biblos-e Archivo: Repositorio Institucional de la UAM Universidad Autónoma de Madrid |
| ISSN: | 1471-2369 |
| Popis: | Background: Spain has dramatically increased the number of controlled circulatory death donors (cDCD). The initial selection criteria for considering cDCD for kidney transplantation (KT) have been expanded progressively, with practically no limits in donor age during the last years. We aimed to analyze the early clinical outcomes using expanded (> 65 years) cDCD in comparison with standard ones. Methods: Observational multicenter study including 19 transplant centers in Spain. We performed a systematic inclusion in a central database of every KT from expanded cDCD at each participant unit from January-2012 to January-2017. Surgical procedures and immunosuppressive protocols were based on local practices. Data was analyzed in the central office using logistic and Cox regression or competitive-risk models for multivariate analysis. Median time of follow-up was 18.1 months. Results: 561 KT were performed with kidneys from cDCD, 135 from donors older than 65 years. As expected, recipients from older cDCD were also older (65.8 (SD 8.8) vs 53.7 (SD 11.4) years; p < 0.001) and with higher comorbidity. At 1 year, no differences were found amongst older and younger cDCD KT recipients in terms of serum creatinine (1.6 (SD 0.7) vs 1.5 (SD 0.8) mg/dl; p = 0.29). Non-death censored graft survival was inferior, but death-censored graft survival was not different (95.5 vs 98.2% respectively; p = 0.481). They also presented a trend towards higher delayed graft function (55.4 vs 46.7%; p = 0.09) but a similar rate of primary non-function (3.7 vs 3.1%; p = 0.71), and acute rejection (3.0 vs 6.3%; p = 0.135). In the multivariate analysis, in short follow-up, donor age was not related with worse survival or poor kidney function (eGFR < 30 ml/min). Conclusions: The use of kidneys from expanded cDCD is increasing for older and comorbid patients. Short-term graft outcomes are similar for expanded and standard cDCD, so they constitute a good-enough source of kidneys to improve the options of KT wait-listed patients This project was co-founded by Public Research Net REDINREN ISCIII 16/009/ 009, Renal Foundation FRIAT & Research Institute Segovia Arana-HU Puerta de Hierro. OLC, PLS and JMP belong to the latter institution (HU Puerta de Hierro). Funding was used for human resources: data manager and statistician support |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink