Patient and Graft Outcomes from Deceased Kidney Donors Age 70 Years and Older: An Analysis of the Organ Procurement Transplant Network/United Network of Organ Sharing Database
| Autor: | Steve Takemoto, Disaya Chavalitdhamrong, Suphamai Bunnapradist, Yong W. Cho, Tariq Shah, Jagbir Gill, Bhaskara R. Madhira |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Graft Rejection Male Tissue and Organ Procurement genetic structures Urinary system computer.software_genre Donor Selection Outcome Assessment Health Care Humans Transplantation Homologous Medicine Organ donation Aged Retrospective Studies Transplantation Database business.industry Incidence Incidence (epidemiology) Graft Survival Hazard ratio Retrospective cohort study Middle Aged Kidney Transplantation Tissue Donors United States Confidence interval Survival Rate surgical procedures operative Relative risk Database Management Systems Kidney Failure Chronic Female business computer Follow-Up Studies |
| Zdroj: | Transplantation. 85:1573-1579 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/tp.0b013e31817059a1 |
| Popis: | Background. The organ shortage has resulted in more use of older deceased donor kidneys. Data are limited on the impact of donor aged 70 years and older on transplant outcomes. We examined patient and graft outcomes of renal transplant from expanded criteria donors (ECDs) aged 70 years and older, using the Organ Procurement Transplant Network/United Network of Organ Sharing database. Methods. We identified 601 deceased donor transplants from donors older than 70 years from 2000 to 2005. The follow-up time was until May 2007. Allograft and patient survival were compared between recipients of transplants from older ECDs (age 70) and younger ECDs (age 50 – 69). The relative risk of graft loss and patient death were determined using multivariate models. Results. The adjusted relative risks of overall graft loss (hazards ratio [HR] 1.37; 95% confidence interval [CI] 1.19 – 1.58), death-censored graft loss (HR 1.32; 95% CI 1.09 –1.61), and patient death (HR 1.37; 95% CI 1.15–1.64) were greater among recipients of transplants from older ECD kidneys. The relative risk of patient death was lower when older ECD kidneys were transplanted into recipients older than 60 compared with recipients aged 41 to 60. In contrast, the relative risk of death-censored graft loss was not increased when older ECD kidneys were transplanted into recipients older than 60. Conclusions. Transplants from older ECD kidneys are associated with a higher risk of graft loss and patient death. The risk was highest when older ECD kidneys were transplanted into recipients younger than 60 years. |
| Databáze: | OpenAIRE |
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