Renal transplantation in the elderly: surgical complications and outcome with special emphasis on the Eurotransplant Senior Programme
| Autor: | Akay Karaoguz, Michael Probst, Jon Jones, Dietger Jonas, Jan Gossmann, Wassilios Bentas, Ernst H. Scheuermann, Ingeborg A. Hauser, Ursula Tilp |
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| Rok vydání: | 2008 |
| Předmět: |
Graft Rejection
Male medicine.medical_specialty Tissue and Organ Procurement medicine.medical_treatment Kaplan-Meier Estimate Statistics Nonparametric Cohort Studies Postoperative Complications fluids and secretions Germany medicine Humans Renal replacement therapy Intensive care medicine Geriatric Assessment Aged Probability Retrospective Studies Transplantation business.industry Incidence General surgery Graft Survival Age Factors Follow up studies Retrospective cohort study biochemical phenomena metabolism and nutrition medicine.disease Kidney Transplantation Survival Analysis Tissue Donors Europe Kidney allocation Nephrology Kidney Failure Chronic Female Hemodialysis business Follow-Up Studies Kidney disease Cohort study |
| Zdroj: | Nephrology Dialysis Transplantation. 23:2043-2051 |
| ISSN: | 1460-2385 0931-0509 |
| DOI: | 10.1093/ndt/gfm912 |
| Popis: | The purpose of this retrospective study was to evaluate the results of the Eurotransplant Senior Programme (ESP) within our centre compared to elderly recipientsor=60 years from the regular Eurotransplant Kidney Allocation System (ETKAS), specifically focusing on surgical aspects.Data from 73 ESP patients (average donor/recipient age: 71.1/67.1) were compared with those from 51 patients (49.7/63.6) treated within the framework of the ETKAS program between the years 1999 and 2006. The mean follow-up was 39.5 months.Cold ischaemic time (ESP versus ETKAS: 10.3 versus 15.0 h), duration of renal replacement therapy (42.2 versus 76.8 months), donor glomerular filtration rate (81.7 versus 109.9 ml/min/1.73 m(2)) and HLA mismatches (4.1 versus 2.4) were significantly different between the two groups (all P0.001). Primary graft function was seen in 74% ESP versus 69% of ETKAS patients (P0.05). The rate of surgical complications in the ESP versus ETKAS group was 47% versus 28% (P = 0.031) and the revision rate, 33% versus 24% (P = 0.259). Three-year patient and censored graft survival was 84% versus 92% and 85% versus 88% in the ESP and ETKAS group, respectively (all P0.05). Ninety-five percent of all deceased patients died with a functioning graft.The donor and recipient pool has been markedly expanded through ESP with similar patient and graft survival compared to elderly recipients grafted according to ETKAS criteria. However, patients and their physicians should be aware of the high surgical complication rate in elderly recipients, particularly when receiving elderly donor kidneys. This might seriously influence postoperative patient management but ultimately does not compromise the transplant outcome. |
| Databáze: | OpenAIRE |
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