scholarly journals Results of Deceased Donor Kidney Transplantation in Young Recipients after Age-matched and Mismatched (Old-to-young) Transplantation

2016 ◽  
Vol 16 (2) ◽  
pp. 8-11
Author(s):  
Janis Jushinskis ◽  
Vadims Suhorukovs ◽  
Aleksandrs Malcevs ◽  
Ieva Ziedina ◽  
Rafails Rozentals
Keyword(s):  
Graft Function ◽  
Deceased Donor ◽  
Rejection Rate ◽  
Donor Age ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Significant Difference ◽  
Deceased Donors ◽  
Kidney Transplantations

SummaryIntroduction.During the previous years the number of organ transplantations from elderly donors increased, and lack of young donors leads to necessity to allocate organs from elderly into young recipients.Aim of the Study.Was to analyse results of “old-to-young” allocation.Material and methods.This retrospective study analysed results of all consecutive deceased donor kidney transplantations (DDKT) performed in one transplant centre during the period from 01.01.2004 till 31.12.2007. Patients were selected based on availability of 5-year follow-up and age < 50 years (158 DDKT). Patients were divided into 2 groups according to donor age: age-mismatched group (donor age was > 55 years and at the same time > 15 years older than recipient; n=8, male/female=2/6, age 39,4 + 4,8 years, donor age 59,4 + 2,4 years), and age-matched group (n=150, male/female=88/62, age 36,0 + 11,0 years, donor age 37,3 + 12,0 years). Groups were compared for clinical and demographical features and posttransplant outcomes (delayed graft function, s-creatinin levels at discharge and after 5 years, acute rejection rate, graft and patient 5-year survival).Results.Comparison of demographical and clinical features revealed only relatively higher BMI in elderly donors (p=0.081) and higher frequency of age-mismatched allocation into female recipients (p=0.066). Early and late post-transplant outcomes showed no significant difference between groups, with similar 5-year graft and patient survival (p=NS for all compared factors).Conclusion.Results showed good kidney allograft function even in cases of age-mismatched allocation, which is significant opportunity in current situation with increasing age of deceased donors.

scholarly journals Young deceased donor kidneys show a survival benefit over older donor kidneys in transplant recipients aged 20–50 years: a study by the ERA–EDTA Registry

2018 ◽  
Vol 35 (3) ◽  
pp. 534-543 ◽  
Author(s):  
Maria Pippias ◽  
Kitty J Jager ◽  
Anders Åsberg ◽  
Stefan P Berger ◽  
Patrik Finne ◽  
...  
Keyword(s):  
Graft Failure ◽  
Cox Regression ◽  
Deceased Donor ◽  
Survival Outcomes ◽  
Regression Methods ◽  
Risk Of Death ◽  
Deceased Donor Kidney ◽  
Deceased Donors ◽  
Kidney Transplantations

Abstract Background Updated survival outcomes of young recipients receiving young or old deceased donor kidneys are required when considering accepting a deceased donor kidney. Methods We examined outcomes in 6448 European kidney allografts donated from younger (≥20–&lt;50 years) and older (≥50–&lt;70 years) deceased donors when transplanted into very young (≥20–&lt;35 years) or young (≥35–&lt;50 years) adult recipients. Outcomes of first kidney transplantations during 2000–13 and followed-up to 2015 were determined via competing risk, restricted mean survival and Cox regression methods. Results The 10-year cumulative incidence of graft failure was lowest in very young {22.0% [95% confidence interval (95% CI) 19.1–24.9]} and young [15.3% (95% CI 13.7–16.9)] recipients of younger donor kidneys and highest in very young [36.7% (95% CI 31.9–41.5)] and young [29.2% (95% CI 25.1–33.2)] recipients of older donor kidneys. At the 10-year follow-up, younger donor kidneys had a 1 year (very young) or 9 months (young) longer mean graft survival time compared with older donor kidneys. Graft failure risk in younger donor kidneys was 45% [very young adjusted hazard ratio (aHR) 0.55 (95% CI 0.44–0.68)] and 40% [young aHR 0.60 (95% CI 0.53–0.67)] lower compared with older donor kidneys. A 1-year increase in donor age resulted in a 2% [very young aHR 1.02 (95% CI 1.00–1.04)] or 1% [young aHR 1.01 (95% CI 1.00–1.01)] increase in the 10-year risk of death. Conclusions Younger donor kidneys show survival benefits over older donor kidneys in adult recipients ages 20–50 years. Updated survival outcomes from older deceased donors are necessary due to advances in transplantation medicine and the increasing role these donors play in organ transplantation.

scholarly journals Effects of Cellular Sensitization and Donor Age on Acute Rejection and Graft Function After Deceased-Donor Kidney Transplantation

2013 ◽  
Vol 95 (10) ◽  
pp. 1254-1258 ◽  
Author(s):  
Donald E. Hricik ◽  
Emilio D. Poggio ◽  
Kenneth J. Woodside ◽  
Naragaju Sarabu ◽  
Edmund Q. Sanchez ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Acute Rejection ◽  
Graft Function ◽  
Deceased Donor ◽  
Donor Age ◽  
Donor Kidney ◽  
Deceased Donor Kidney ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

scholarly journals Endogenous intronic antisense long non-coding RNA, MGAT3-AS1, and kidney transplantation

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Subagini Nagarajah ◽  
Shengqiang Xia ◽  
Marianne Rasmussen ◽  
Martin Tepel
Keyword(s):  
Kidney Transplantation ◽  
Predictive Value ◽  
Graft Function ◽  
Deceased Donor ◽  
Delayed Graft Function ◽  
Transplant Recipients ◽  
Donor Kidney ◽  
Non Coding Rna ◽  
Deceased Donor Kidney ◽  
Long Non Coding Rna

Abstract β-1,4-mannosylglycoprotein 4-β-N-acetylglucosaminyltransferase (MGAT3) is a key molecule for the innate immune system. We tested the hypothesis that intronic antisense long non-coding RNA, MGAT3-AS1, can predict delayed allograft function after kidney transplantation. We prospectively assessed kidney function and MGAT3-AS1 in 129 incident deceased donor kidney transplant recipients before and after transplantation. MGAT3-AS1 levels were measured in mononuclear cells using qRT-PCR. Delayed graft function was defined by at least one dialysis session within 7 days of transplantation. Delayed graft function occurred in 22 out of 129 transplant recipients (17%). Median MGAT3-AS1 after transplantation was significantly lower in patients with delayed graft function compared to patients with immediate graft function (6.5 × 10−6, IQR 3.0 × 10−6 to 8.4 × 10−6; vs. 8.3 × 10−6, IQR 5.0 × 10−6 to 12.8 × 10−6; p < 0.05). The median preoperative MGAT3-AS1 was significantly lower in kidney recipients with delayed graft function (5.1 × 10−6, IQR, 2.4 × 10−6 to 6.8 × 10−6) compared to recipients with immediate graft function (8.9 × 10−6, IQR, 6.8 × 10−6 to 13.4 × 10−6; p < 0.05). Receiver-operator characteristics showed that preoperative MGAT3-AS1 predicted delayed graft function (area under curve, 0.83; 95% CI, 0.65 to 1.00; p < 0.01). We observed a positive predictive value of 0.57, and a negative predictive value of 0.95. Long non-coding RNA, MGAT3-AS1, indicates short-term outcome in patients with deceased donor kidney transplantation.

scholarly journals Urinary Biomarkers α-GST and π-GST for Evaluation and Monitoring in Living and Deceased Donor Kidney Grafts

2019 ◽  
Vol 8 (11) ◽  
pp. 1899 ◽  
Author(s):  
Shadi Katou ◽  
Brigitta Globke ◽  
M. Haluk Morgul ◽  
Thomas Vogel ◽  
Benjamin Struecker ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Function ◽  
Rejection Sensitivity ◽  
Deceased Donor ◽  
Urine Samples ◽  
Kidney Graft ◽  
Donor Kidney ◽  
Kidney Recipients ◽  
Deceased Donor Kidney ◽  
Brain Dead

The aim of this study was to analyze the value of urine α- and π-GST in monitoring and predicting kidney graft function following transplantation. In addition, urine samples from corresponding organ donors was analyzed and compared with graft function after organ donation from brain-dead and living donors. Urine samples from brain-dead (n = 30) and living related (n = 50) donors and their corresponding recipients were analyzed before and after kidney transplantation. Urine α- and π-GST values were measured. Kidney recipients were grouped into patients with acute graft rejection (AGR), calcineurin inhibitor toxicity (CNI), and delayed graft function (DGF), and compared to those with unimpaired graft function. Urinary π-GST revealed significant differences in deceased kidney donor recipients with episodes of AGR or DGF at day one after transplantation (p = 0.0023 and p = 0.036, respectively). High π-GST values at postoperative day 1 (cutoff: >21.4 ng/mg urine creatinine (uCrea) or >18.3 ng/mg uCrea for AGR or DGF, respectively) distinguished between rejection and no rejection (sensitivity, 100%; specificity, 66.6%) as well as between DGF and normal-functioning grafts (sensitivity, 100%; specificity, 62.6%). In living donor recipients, urine levels of α- and π-GST were about 10 times lower than in deceased donor recipients. In deceased donors with impaired graft function in corresponding recipients, urinary α- and π-GST were elevated. α-GST values >33.97 ng/mg uCrea were indicative of AGR with a sensitivity and specificity of 77.7% and 100%, respectively. In deceased donor kidney transplantation, evaluation of urinary α- and π-GST seems to predict different events that deteriorate graft function. To elucidate the potential advantages of such biomarkers, further analysis is warranted.

scholarly journals Predictors and one-year outcomes of patients with delayed graft function after deceased donor kidney transplantation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Rao Chen ◽  
Haifeng Wang ◽  
Lei Song ◽  
Jianfei Hou ◽  
Jiawei Peng ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Graft Survival ◽  
Graft Function ◽  
Deceased Donor ◽  
Donor Kidney ◽  
Ischemic Time ◽  
Deceased Donor Kidney ◽  
One Year ◽  
Donor Kidney Transplantation ◽  
Deceased Donor Kidney Transplantation

Abstract Background Delayed graft function (DGF) is closely associated with the use of marginal donated kidneys due to deficits during transplantation and in recipients. We aimed to predict the incidence of DGF and evaluate its effect on graft survival. Methods This retrospective study on kidney transplantation was conducted from January 1, 2018, to December 31, 2019, at the Second Xiangya Hospital of Central South University. We classified recipients whose operations were performed in different years into training and validation cohorts and used data from the training cohort to analyze predictors of DGF. A nomogram was then constructed to predict the likelihood of DGF based on these predictors. Results The incidence rate of DGF was 16.92%. Binary logistic regression analysis showed correlations between the incidence of DGF and cold ischemic time (CIT), warm ischemic time (WIT), terminal serum creatine (Scr) concentration, duration of pretransplant dialysis, primary cause of donor death, and usage of LifePort. The internal accuracy of the nomogram was 83.12%. One-year graft survival rates were 93.59 and 99.74%, respectively, for the groups with and without DGF (P < 0.05). Conclusion The nomogram established in this study showed good accuracy in predicting DGF after deceased donor kidney transplantation; additionally, DGF decreased one-year graft survival.

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