Comparative study of the outcomes of the second kidney transplantation from the young deceased donors versus living-unrelated donors

The efforts in the late 1940s to 1960s of two Parisian pioneers in kidney transplantation, René Kűss, a surgeon, and Jean Hamburger, a nephrologist, have largely been forgotten. Küss developed the operation that is basically unchanged today. Both groups initiated clinical transplant programs in January 1951, and both were among the first to carry out kidney transplantation (i) without immunosuppressive therapy, (ii) between living-related and unrelated donors, (iii) with organs from deceased donors, (iv) with irradiation and immunosuppressive drugs, and (v) with long-term survival. In the opinion of many, the French did not receive full credit for their work internationally.

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Rate, Factors, and Outcome of Delayed Graft Function After Kidney Transplantation of Deceased Donors

Transplantation Proceedings ◽

10.1016/j.transproceed.2021.01.006 ◽

2021 ◽

Author(s):

Laura Jahn ◽

Christiane Rüster ◽

Mandy Schlosser ◽

Yvonne Winkler ◽

Susan Foller ◽

...

Keyword(s):

Kidney Transplantation ◽

Graft Function ◽

Delayed Graft Function ◽

Deceased Donors

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Kidney transplantation in the extremely elderly from extremely aged deceased donors: a kidney for each age

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz293 ◽

2020 ◽

Vol 35 (4) ◽

pp. 687-696

Author(s):

Jimena Cabrera ◽

Mario Fernández-Ruiz ◽

Hernando Trujillo ◽

Esther González ◽

María Molina ◽

...

Keyword(s):

Kidney Transplantation ◽

Graft Survival ◽

Cox Regression ◽

Patient Survival ◽

Incidence Rates ◽

Allocation Policy ◽

Recipient Age ◽

Deceased Donors ◽

Stage Renal Disease ◽

End Stage

Abstract Background Advances in life expectancy have led to an increase in the number of elderly people with end-stage renal disease (ESRD). Scarce information is available on the outcomes of kidney transplantation (KT) in extremely elderly patients based on an allocation policy prioritizing donor–recipient age matching. Methods We included recipients ≥75 years that underwent KT from similarly aged deceased donors at our institution between 2002 and 2015. Determinants of death-censored graft and patient survival were assessed by Cox regression. Results We included 138 recipients with a median follow-up of 38.8 months. Median (interquartile range) age of recipients and donors was 77.5 (76.3–79.7) and 77.0 years (74.7–79.0), with 22.5% of donors ≥80 years. Primary graft non-function occurred in 8.0% (11/138) of patients. Cumulative incidence rates for post-transplant infection and biopsy-proven acute rejection (BPAR) were 70.3% (97/138) and 15.2% (21/138), respectively. One- and 5-year patient survival were 82.1 and 60.1%, respectively, whereas the corresponding rates for death-censored graft survival were 95.6 and 93.1%. Infection was the leading cause of death (46.0% of fatal cases). The occurrence of BPAR was associated with lower 1-year patient survival [hazard ratio (HR) = 4.21, 95% confidence interval (CI) 1.64–10.82; P = 0.003]. Diabetic nephropathy was the only factor predicting 5-year death-censored graft survival (HR = 4.82, 95% CI 1.08–21.56; P = 0.040). Conclusions ESRD patients ≥75 years can access KT and remain dialysis free for their remaining lifespan by using grafts from extremely aged deceased donors, yielding encouraging results in terms of recipient and graft survival.

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