scholarly journals Matching Older Kidneys with Older Patients Does Not Improve Allograft Survival

2002 ◽  
Vol 13 (4) ◽  
pp. 1067-1072
Author(s):  
Bertram L. Kasiske ◽  
Jon Snyder
Keyword(s):  
Confidence Interval ◽  
Graft Survival ◽  
Graft Failure ◽  
The United States ◽  
Independent Effect ◽  
Donor Age ◽  
Recipient Age ◽  
Kidney Transplantations ◽  
Using Data ◽  
Older Recipients

ABSTRACT. Centers may restrict the use of some donor kidneys on the belief that overall graft survival is improved by giving older kidneys to older recipients andvice versa. The prevalence and the effect on graft survival (determined by death, return to dialysis, or retransplantation) of this practice among 74,297 first cadaver kidney transplantations in 1988 to 1998 was examined by using data from the United States Renal Data System. Giving older kidneys to older recipients is common; recipients ≥55 yr old received donor kidneys that were ≥55 yr old 46.2% more often than expected, but they received kidneys that were 18 to 29 yr old 33.6% less often than expected (χ2P< 0.0001). Both recipient and donor age have important effects on graft survival, although the effects of donor age are much stronger than those of recipient age. Compared with recipients 18 to 29 yr old, recipients ≥55 yr old were 25% (95% confidence interval, 15 to 35%,P< 0.0001) more likely to have graft failure (adjusted for donor age and other risk factors). On the other hand, donor kidneys ≥55 yr old were 78% (95% confidence interval, 58 to 99%,P< 0.0001) more likely to fail compared with kidneys 18 to 29 yr old. However, giving older kidneys to older recipients had little independent effect on graft survival, once the intrinsic effects of recipient and donor age were taken into account. For example, transplanting donor kidneys ≥55 yr old into recipients ≥55 yr old reduced the risk of graft failure only −6% (95% confidence interval, −18 to 8%,P= 0.3923) after the independent effects of donor and recipient ageper sewere taken into account. Thus, giving older kidneys to older recipients is a common practice that does not improve overall graft survival.

Role of Donor Age and Acute Rejection Episodes on Long-Term Graft Survival in Cadaveric Kidney Transplantations

2005 ◽  
Vol 37 (7) ◽  
pp. 2954-2956 ◽  
Author(s):  
R. Emiroğlu ◽  
M.C. Yagmurdur ◽  
F. Karakayali ◽  
C. Haberal ◽  
U. Ozcelik ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Graft Survival ◽  
Donor Age ◽  
Kidney Transplantations ◽  
Cadaveric Kidney

THE EFFECT OF DONOR AGE, RECIPIENT AGE, AND HLA MATCH ON IMMUNOLOGIC GRAFT SURVIVAL IN CADAVER RENAL TRANSPLANT RECIPIENTS1

1992 ◽  
Vol 53 (1) ◽  
pp. 55-58 ◽  
Author(s):  
JOHN D. PIRSCH ◽  
ANTHONY M. DʼALESSANDRO ◽  
HANS W. SOLLINGER ◽  
ROBERT M. HOFFMANN ◽  
ELLEN ROECKER ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Graft Survival ◽  
Donor Age ◽  
Recipient Age

scholarly journals The association between socioeconomic status and autism diagnosis in the United Kingdom for children aged 5–8 years of age: Findings from the Born in Bradford cohort

Autism ◽  
2017 ◽  
Vol 23 (1) ◽  
pp. 131-140 ◽  
Author(s):  
Brian Kelly ◽  
Stefan Williams ◽  
Sylvie Collins ◽  
Faisal Mushtaq ◽  
Mark Mon-Williams ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
United Kingdom ◽  
Confidence Interval ◽  
The United States ◽  
Autism Diagnosis ◽  
The United Kingdom ◽  
Income Status ◽  
Born In Bradford ◽  
Education Status ◽  
Using Data

There has been recent interest in the relationship between socioeconomic status and the diagnosis of autism in children. Studies in the United States have found lower rates of autism diagnosis associated with lower socioeconomic status, while studies in other countries report no association, or the opposite. This article aims to contribute to the understanding of this relationship in the United Kingdom. Using data from the Born in Bradford cohort, comprising 13,857 children born between 2007 and 2011, it was found that children of mothers educated to A-level or above had twice the rate of autism diagnosis, 1.5% of children (95% confidence interval: 1.1%, 1.9%) compared to children of mothers with lower levels of education status 0.7% (95% confidence interval: 0.5%, 0.9%). No statistically significant relationship between income status or neighbourhood material deprivation was found after controlling for mothers education status. The results suggest a substantial level of underdiagnosis for children of lower education status mothers, though further research is required to determine the extent to which this is replicated across the United Kingdom. Tackling inequalities in autism diagnosis will require action, which could include increased education, awareness, further exploration of the usefulness of screening programmes and the provision of more accessible support services.

Latino Immigrant Home-Country Media Use and Participation in U.S. Politics

2018 ◽  
Vol 40 (1) ◽  
pp. 37-56
Author(s):  
Xavier Medina Vidal
Keyword(s):  
United States ◽  
News Media ◽  
Multivariate Analyses ◽  
Home Country ◽  
Media Use ◽  
The United States ◽  
Latino Immigrants ◽  
Independent Effect ◽  
Political Protests ◽  
Using Data

This article examines the ways in which Latino immigrants’ use of news media from their home countries influences their likelihood of participating in politics in the United States. Using data from the 2015 Latino National Health and Immigration Survey of 1,005 Latino adults in the United States, I run a set of multivariate analyses to determine whether home-country media use affects the likelihood that Latino immigrants, 52% of whom use home-country media at least a few times per week, will vote, participate in political protests, attend meetings, sign a petition, or make a donation to political causes. I find that home-country media use has a significant, independent effect on the likelihood of protesting and signing petitions. This article bridges our understanding of media effects on participation for Latino immigrants and the importance of transnational political behavior to civic participation and incorporation of immigrants in the United States.

P6317Recipient or donor age in heart transplantation:which one fits more?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Di Nora ◽  
A Lechiancole ◽  
V Ferrara ◽  
S Sponga ◽  
V Tursi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
P Value ◽  
Donor Age ◽  
Group 4 ◽  
Surgical Data ◽  
Recipient Age ◽  
Group 2 ◽  
The Impact ◽  
Older Recipients ◽  
Group 1

Abstract Increasing recipient (RA) and donor age (DA) are independently associated with mortality after Heart Transplantation (HT). The aim of this study was to analyse the impact of age-matching on HT survival. 485 recipients who underwent HT between 1990 and 2018 in our Institution were divided into four groups: RA<60-DA<50 (Group 1), RA<60-DA>50 (Group 2), RA>60-DA<50 (Group 3), RA>60-DA>50 (Group 4), and their outcomes were compared. Emergency HT, bridge with MCS and re-HT were excluded. Mean follow-up was 109±84 months. The survival of Group 1 patients was significantly higher than that of patients in other groups (p=0.001). The outcome of young recipients who received older donor grafts did not significantly differ from that of older recipients. At multivariate analysis, donor age, recipient age, Diabetes Mellitus and hypercholesterolemia correlated with long-term mortality. Demographic variables 1 (d/r) 2 (r/D) 3 (R/d) 4 (D/R) P Value Recipients data   No. of patients 241 61 107 76 –   Female, n (%) 50 (21) 16 (26) 17 (16) 11 (14) 0.25   Age (years), mean ± sd 49±10 54±7 64±3 65±3 <0.001*   Creatinine (mg/dl), mean ± sd 1.3±0.8 1.5±0.5 1.4±0.4 1.5±0.5 0.49   Diabetes Mellitus, n (%) 33 (14) 17 (28) 38 (36) 30 (39) <0.001*   Hb (g/dl), mean ± sd 12.9±2.4 11.5±2 13±1.7 12±2 0.08   Tot. Bilirubin (mg/dl), mean ± sd 1.3±1 1±0.6 1.2±0.8 1.1±0.7 0.63   sPAP (mmHg), mean ± sd 42.4±14.2 47.5±15.9 44.6±14.8 49.6±16.2 0.07 Etiology 0.003*   Ischemic, n (%) 74 (30) 25 (41) 55 (51) 40 (53)   Dilative, n (%) 110 (46) 24 (39) 40 (37) 29 (38)   Valvular, n (%) 19 (8) 5 (8) 5 (5) 5 (6) Donors and Surgical data   Age, (years) mean ± sd 31±10.5 56.5±4 36±10.5 57.5±4.5 <0.001*   Female sex, n (%) 73 (30) 30 (49) 38 (35) 33 (43) 0.02*   LVEF, mean ± sd 58±4 56±5 60±9 63±9 0.73   Graft ischemia time (min), mean ± sd 198±63 205±62 209±64 193±69 0.75   ECC time (min), mean ± sd 218±72 213±64 214±70 192±53 0.45 In this study, the use of hearts from older donors did not affect survival of older recipients; conversely, in young recipients it increased the risk of mortality.

scholarly journals Donor Age, Donor-Recipient Size Mismatch, and Kidney Graft Survival

2020 ◽  
Vol 15 (10) ◽  
pp. 1455-1463
Author(s):  
Fanny Lepeytre ◽  
Catherine Delmas-Frenette ◽  
Xun Zhang ◽  
Stéphanie Larivière-Beaudoin ◽  
Ruth Sapir-Pichhadze ◽  
...  
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Graft Survival ◽  
Body Surface ◽  
Area Ratio ◽  
Transplant Recipients ◽  
Donor Age ◽  
Surface Area Ratio ◽  
Size Mismatch ◽  
Recipient Age

Background and objectivesSmall donor and/or kidney sizes relative to recipient size are associated with a higher risk of kidney allograft failure. Donor and recipient ages are associated with graft survival and may modulate the relationship between size mismatch and the latter. The aim of this study was to determine whether the association between donor-recipient size mismatch and graft survival differs by donor and recipient age.Design, setting, participants, & measurementWe performed a retrospective cohort study of first adult deceased donor kidney transplantations performed between 2000 and 2018 recorded in the Scientific Registry of Transplant Recipients. We used multivariable Cox proportional hazards models to assess the association between donor-recipient body surface area ratio and death-censored graft survival, defined as return to dialysis or retransplantation. We considered interactions between donor-recipient body surface area ratio and each of recipient and donor age.ResultsAmong the 136,321 kidney transplant recipients included in this study, 23,614 (17%) experienced death-censored graft loss over a median follow-up of 4.3 years (interquartile range, 1.9–7.8 years). The three-way donor-recipient body surface area ratio by donor age by recipient age interaction was statistically significant (P=0.04). The magnitude of the association between severe size mismatch (donor-recipient body surface area ratio <0.80 versus ≥1.00) and death-censored graft survival was stronger with older donor age and recipient age. In all recipient age categories except the youngest (18–30 years), 5- and 10-year graft survival rates were similar or better with a size-mismatched donor aged <40 years than a nonsize-mismatched donor aged 40 years or older.ConclusionsThe association of donor-recipient size mismatch on long-term graft survival is modulated by recipient and donor age. Size-mismatched kidneys yield excellent graft survival when the donor is young. Donor age was more strongly associated with graft survival than size mismatch.

scholarly journals Over Ten-Year Kidney Graft Survival Determinants

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Anabela Malho Guedes ◽  
Jorge Malheiro ◽  
Isabel Fonseca ◽  
La Salete Martins ◽  
Sofia Pedroso ◽  
...  
Keyword(s):  
Graft Survival ◽  
Graft Failure ◽  
Graft Function ◽  
Kidney Graft ◽  
Donor Age ◽  
Patient Death ◽  
Chi Square ◽  
Predictive Variables ◽  
Chi Square Test

Kidney graft survival has been mainly evaluated using an up to 10-year threshold. Instead, in this study our aim was to evaluate predictive variables that impact long-term kidney graft survival (≥10 years). We enrolled 892 patients in our analysis: 638 patients with functioning graft at 10 years PT and 254 patients with graft failure at 10 years PT (considering patient death with a functioning graft <10 years PT as graft failure). Between groups comparisons were done using Mann-Whitney and chi-square test. To determine independent predictive variables for long-term graft survival a multivariate-adjusted logistic regression was performed. Significant predictors of long term graft survival were lower 12-month PT creatinine (, ), lower donor age (, ), shorter time on dialysis (, ), recipient positive CMV IgG (, ), absence of AR episodes (, ), 0 to 1 (versus 2) HLA-B mismatch (, ), and recipients male gender (, ). Our results show that an early KT, younger donor age, and an optimal first year graft function are of paramount importance for long-term graft survival. Measures that address these issues (careful donor selection, preemptive KT, and effective immunosuppressive protocols) are still warranted.

scholarly journals Risk Factors for 1-Year Graft Loss After Kidney Transplantation

2019 ◽  
Vol 14 (11) ◽  
pp. 1642-1650 ◽  
Author(s):  
Farid Foroutan ◽  
Erik Loewen Friesen ◽  
Kathryn Elizabeth Clark ◽  
Shahrzad Motaghi ◽  
Roman Zyla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Graft Loss ◽  
Graft Function ◽  
Delayed Graft Function ◽  
Donor Age ◽  
Degree Of Certainty ◽  
Recipient Age ◽  
High Degree

Background and objectivesWith expansion of the pool of kidney grafts, through the use of higher-risk donors, and increased attention to donor management strategies, the 1-year graft survival rate is subject to change. It is, therefore, useful to elucidate 1-year graft survival rates by dissecting the characteristics of the low-risk and high-risk kidney transplant cases. The objective of our study was to evaluate factors purported to influence the risk of 1-year graft loss in kidney transplant recipients.Design, setting, participants, & measurementsWe searched bibliographic databases from 2000 to 2017 and included observational studies that measured the association between donor, recipient, the transplant operation, or early postoperative complications, and 1-year death-censored graft loss.ResultsWe identified 35 eligible primary studies, with 20 risk factors amenable to meta-analysis. Six factors were associated with graft loss, with moderate to high degree of certainty: donor age (hazard ratio [HR], 1.11 per 10-year increase; 95% confidence interval [95% CI], 1.04 to 1.18), extended criteria donors (HR, 1.35; 95% CI, 1.28 to 1.42), deceased donors (HR, 1.54; 95% CI, 1.32 to 1.82), number of HLA mismatches (HR, 1.08 per one mismatch increase; 95% CI, 1.07 to 1.09), recipient age (HR, 1.17 per 10-year increase; 95% CI, 1.09 to 1.25), and delayed graft function (HR, 1.89; 95% CI, 1.46 to 2.47) as risk factors for 1-year graft loss. Pooled analyses also excluded, with a high degree of certainty, any associations of cold ischemia time, recipient race, pretransplant body mass index, diabetes, and hypertension with 1-year graft loss.ConclusionsRecipient age, donor age, standard versus extended criteria donor, living versus deceased donor, HLA mismatch, and delayed graft function all predicted 1-year graft survival. The effect of each risk factor is small.

Kidney Graft Survival in Italy and Factors Influencing it

2005 ◽  
Vol 15 (4) ◽  
pp. 385-391 ◽  
Author(s):  
Orsola Pugliese ◽  
Francesca Quintieri ◽  
Dino Alberto Mattucci ◽  
Sante Venettoni ◽  
Emanuela Taioli ◽  
...  
Keyword(s):  
Graft Survival ◽  
Developed Countries ◽  
National Registry ◽  
Kidney Graft ◽  
Allograft Function ◽  
Recipient Age ◽  
Transplant Registry ◽  
Using Data ◽  
National Registry Data

Purpose National registry data are often a suitable basis for examination of transplant outcomes. Using data supplied by the Italian National Transplant Registry, established in 1995, we performed the first nationwide analysis of this kind. Methods A retrospective analysis of 4893 recipients of cadaveric kidneys transplanted in all Italian centers from 1995 through 2000 was done to study 5-year graft survival. The association between some donor and recipient variables and outcomes in renal transplantation was analyzed. Graft survival was 93% at 3 months, 89% at 1 year, 82% at 3 years, and 80% at 5 years after transplantation. Results A significant association between graft survival and donor age (old vs young, relative risk [RR] = 1.62, 95% CI 1.27–2.06) and recipient age (old vs young, RR = 1.25, 95% CI 1.02–1.53). Graft survival was also associated with cold ischemia time (24–36 hours, RR=1.39, 95% CI 1.05–1.85 and >36 hours, RR=1.94, 95% CI 1.32–2.86 vs 0–24 hours) and donor/recipient sex mismatch (female/male vs male/male, RR=1.50, 95% CI 1.17–1.93). Conclusion The quality of kidney transplantation in Italy is satisfactory and is comparable to that in other developed countries. Furthermore, our experience confirms that both donor and recipient factors are major determinants of renal allograft function.

scholarly journals Recipient Age and Weight Affect Chronic Renal Allograft Rejection in Rats

2001 ◽  
Vol 12 (8) ◽  
pp. 1742-1749
Author(s):  
SHANYING LIU ◽  
JENS LUTZ ◽  
BALAZS ANTUS ◽  
YOUSHENG YAO ◽  
SOHYUN BAIK ◽  
...  
Keyword(s):  
Growth Factor ◽  
Graft Survival ◽  
Transforming Growth Factor ◽  
Vascular Lesions ◽  
Donor Age ◽  
Long Term Outcomes ◽  
Kidney Weight ◽  
Age Related ◽  
Recipient Age

Abstract. Nephron doses and immune responses change with age. Therefore, age is a potential risk factor for graft survival after kidney transplantation. The aim of this study was to determine whether age-related differences are of importance for long-term outcomes after renal transplantation. Kidneys from Fisher 344 rats were orthotopically transplanted into nephrectomized Lewis rats. Kidneys were transplanted using donors and recipients of three age levels,i.e., young (8 wk of age), adult (16 wk of age), and old (40 wk of age). Rats were killed 24 wk after transplantation, and functional, morphologic, and molecular evaluations were performed. Recipient age, rather than donor age, determined graft survival rates. No significant correlation was observed between donor kidney weight on the day of transplantation and morphologic results. Advanced recipient age was associated with reduced creatinine clearance, more severe histologic injuries, including extended glomerular sclerosis, interstitial fibrosis, and vascular lesions, more pronounced cellular infiltration, and greater expression of transforming growth factor-β and platelet-derived growth factor A and B chains. Although no significant correlation between donor age or kidney weight on the day of transplantation and morphologic results was observed, there was a significant correlation between recipient body weight on the day of transplantation and allograft injury. It is concluded that recipient age and weight affect chronic renal rejection. Renal allografts may benefit from young recipient age but may deteriorate in old recipients, suggesting effects of recipient functional demand on long-term outcomes.

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