Document Detail


Long-term results of biopsy-guided selection and allocation of kidneys from older donors in older recipients.
MedLine Citation:
PMID:  22702444     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In our old-for-old program, we discard or allocate older extended criteria donor kidneys to single (SKT) or dual kidney transplantation (DKT) depending on histological Remuzzi's score in recipients older than 60 years. Here, we analyze the long-term results of this program and try to identify independent predictors of patient and graft survival. Between December 1996 and January 2008, we performed 115 SKT and 88 DKT. Discard rate was 15%. Acute rejection incidence was higher in SKT than in DKT (22.6% vs. 11.4%, p = 0.04). Renal function was better in DKT than in SKT up to 5 years after transplantation. Surgical complications were frequent in DKT. Ten-year cumulative graft survival was significantly lower in the SKT group (31% vs. 53%, p = 0.03). In SKT, histological score 4 provided similar graft survival than 3 or less, whereas in DKT score 4, 5 or 6 displayed similar outcome. Finally, independent predictors of graft survival were history of major adverse cardiac event and 1-year serum creatinine, rather than SKT or DKT. In conclusion, this biopsy-guided old-for-old strategy resulted in acceptable long-term graft survival. Our results suggest that DKT should be considered for scores of 5 or 6 only.
Authors:
L Fernández-Lorente; L Riera; O Bestard; M Carrera; M Gomà; N Porta; J Torras; E Melilli; S Gil-Vernet; J M Grinyó; J M Cruzado
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-06-15
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  12     ISSN:  1600-6143     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-26     Completed Date:  2013-02-25     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2781-8     Citation Subset:  IM    
Copyright Information:
© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.
Affiliation:
Nephrology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Aged
Biopsy
Female
Health Care Rationing*
Humans
Kidney Transplantation*
Male
Middle Aged
Tissue Donors*
Comments/Corrections
Comment In:
J Urol. 2013 Apr;189(4):1454-5   [PMID:  23561368 ]
J Urol. 2013 Apr;189(4):1454   [PMID:  23561367 ]

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