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
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 Orga...
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| Veröffentlicht in: | Transplantation 2008-06, Vol.85 (11), p.1573-1579 |
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| creator | CHAVALITDHAMRONG, Disaya GILL, Jagbir TAKEMOTO, Steve MADHIRA, Bhaskara R CHO, Yong W SHAH, Tariq BUNNAPRADIST, Suphamai |
| description | 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.
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 > or =70) and younger ECDs (age 50-69). The relative risk of graft loss and patient death were determined using multivariate models.
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.
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. |
| doi_str_mv | 10.1097/TP.0b013e31817059a1 |
| format | Article |
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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 > or =70) and younger ECDs (age 50-69). The relative risk of graft loss and patient death were determined using multivariate models.
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.
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.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/TP.0b013e31817059a1</identifier><identifier>PMID: 18551062</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Clinical death. Palliative care. Organ gift and preservation ; Database Management Systems - statistics & numerical data ; Donor Selection - standards ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Graft Rejection - epidemiology ; Graft Survival ; Humans ; Incidence ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - surgery ; Kidney Transplantation - statistics & numerical data ; Male ; Medical sciences ; Middle Aged ; Outcome Assessment (Health Care) - methods ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Survival Rate - trends ; Tissue and Organ Procurement - statistics & numerical data ; Tissue Donors - statistics & numerical data ; Tissue, organ and graft immunology ; Transplantation, Homologous ; United States - epidemiology</subject><ispartof>Transplantation, 2008-06, Vol.85 (11), p.1573-1579</ispartof><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-ebfff0c21b32340339567fddba45fc9c306dac4ec8290f96497562d32e2788ea3</citedby><cites>FETCH-LOGICAL-c440t-ebfff0c21b32340339567fddba45fc9c306dac4ec8290f96497562d32e2788ea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20447683$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18551062$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CHAVALITDHAMRONG, Disaya</creatorcontrib><creatorcontrib>GILL, Jagbir</creatorcontrib><creatorcontrib>TAKEMOTO, Steve</creatorcontrib><creatorcontrib>MADHIRA, Bhaskara R</creatorcontrib><creatorcontrib>CHO, Yong W</creatorcontrib><creatorcontrib>SHAH, Tariq</creatorcontrib><creatorcontrib>BUNNAPRADIST, Suphamai</creatorcontrib><title>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</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>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.
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 > or =70) and younger ECDs (age 50-69). The relative risk of graft loss and patient death were determined using multivariate models.
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.
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Clinical death. Palliative care. Organ gift and preservation</subject><subject>Database Management Systems - statistics & numerical data</subject><subject>Donor Selection - standards</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Graft Rejection - epidemiology</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kidney Failure, Chronic - mortality</subject><subject>Kidney Failure, Chronic - surgery</subject><subject>Kidney Transplantation - statistics & numerical data</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Outcome Assessment (Health Care) - methods</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Survival Rate - trends</subject><subject>Tissue and Organ Procurement - statistics & numerical data</subject><subject>Tissue Donors - statistics & numerical data</subject><subject>Tissue, organ and graft immunology</subject><subject>Transplantation, Homologous</subject><subject>United States - epidemiology</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9q3DAQh0VpaTZpn6BQdGlvTkZ_bNm9Ldk2LQ3dhW4OPRlZHm3c2tZGkin7VnnEalnTQi8BwWjg-2YGfoS8YXDJoFJX280lNMAEClYyBXml2TOyYLmQWQElPCcLAMkyJoQ6I-ch_ASAXCj1kpyxMs8ZFHxBHjc6djhGqseW3nhtI11P0bgBA7XeDXSFBnXAln7t2hEPdOVG5wNd7pAqoD9Qp-borvsWPf1Al2N6uj-ELlBnabxHuvY7PdKNd2byOByXbb0ew77X6fsN42_nf13djV1MW-b2qJ607_fad-OOrnTUTTrkFXlhdR_w9VwvyN2nj9vrz9nt-ubL9fI2M1JCzLCx1oLhrBFcSBCiygtl27bRMremMgKKVhuJpuQV2KqQlcoL3gqOXJUlanFB3p_m7r17mDDEeuiCwT4djW4KtWJFMoR8EuQMRAkVPAmyipd5VYoEihNovAvBo633vhu0P9QM6mP09XZT_x99st7O46dmwPafM2edgHczoIPRvU0ZmC785ThIqYq0_g_Wg7go</recordid><startdate>20080615</startdate><enddate>20080615</enddate><creator>CHAVALITDHAMRONG, Disaya</creator><creator>GILL, Jagbir</creator><creator>TAKEMOTO, Steve</creator><creator>MADHIRA, Bhaskara R</creator><creator>CHO, Yong W</creator><creator>SHAH, Tariq</creator><creator>BUNNAPRADIST, Suphamai</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20080615</creationdate><title>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</title><author>CHAVALITDHAMRONG, Disaya ; GILL, Jagbir ; TAKEMOTO, Steve ; MADHIRA, Bhaskara R ; CHO, Yong W ; SHAH, Tariq ; BUNNAPRADIST, Suphamai</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-ebfff0c21b32340339567fddba45fc9c306dac4ec8290f96497562d32e2788ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Clinical death. Palliative care. Organ gift and preservation</topic><topic>Database Management Systems - statistics & numerical data</topic><topic>Donor Selection - standards</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Graft Rejection - epidemiology</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kidney Failure, Chronic - mortality</topic><topic>Kidney Failure, Chronic - surgery</topic><topic>Kidney Transplantation - statistics & numerical data</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Outcome Assessment (Health Care) - methods</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Survival Rate - trends</topic><topic>Tissue and Organ Procurement - statistics & numerical data</topic><topic>Tissue Donors - statistics & numerical data</topic><topic>Tissue, organ and graft immunology</topic><topic>Transplantation, Homologous</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CHAVALITDHAMRONG, Disaya</creatorcontrib><creatorcontrib>GILL, Jagbir</creatorcontrib><creatorcontrib>TAKEMOTO, Steve</creatorcontrib><creatorcontrib>MADHIRA, Bhaskara R</creatorcontrib><creatorcontrib>CHO, Yong W</creatorcontrib><creatorcontrib>SHAH, Tariq</creatorcontrib><creatorcontrib>BUNNAPRADIST, Suphamai</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CHAVALITDHAMRONG, Disaya</au><au>GILL, Jagbir</au><au>TAKEMOTO, Steve</au><au>MADHIRA, Bhaskara R</au><au>CHO, Yong W</au><au>SHAH, Tariq</au><au>BUNNAPRADIST, Suphamai</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2008-06-15</date><risdate>2008</risdate><volume>85</volume><issue>11</issue><spage>1573</spage><epage>1579</epage><pages>1573-1579</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>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.
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 > or =70) and younger ECDs (age 50-69). The relative risk of graft loss and patient death were determined using multivariate models.
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.
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.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>18551062</pmid><doi>10.1097/TP.0b013e31817059a1</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Transplantation, 2008-06, Vol.85 (11), p.1573-1579 |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Clinical death. Palliative care. Organ gift and preservation Database Management Systems - statistics & numerical data Donor Selection - standards Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Fundamental immunology Graft Rejection - epidemiology Graft Survival Humans Incidence Kidney Failure, Chronic - mortality Kidney Failure, Chronic - surgery Kidney Transplantation - statistics & numerical data Male Medical sciences Middle Aged Outcome Assessment (Health Care) - methods Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Survival Rate - trends Tissue and Organ Procurement - statistics & numerical data Tissue Donors - statistics & numerical data Tissue, organ and graft immunology Transplantation, Homologous United States - epidemiology |
| title | 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 |
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