BACKGROUND: The results of the transplantation of marginal donor kidneys remain controversial. This study aimed to investigate the impact of donor risk factors as predictors of kidney-graft outcome. METHODS: Allograft failure risk factors were studied in 7,209 cadaveric kidney-transplant recipients reporting to the Etablissement français des Greffes (EfG) from 1996 to 2000, of which 544 (7.6%) were from donors aged over 60. Both univariate and multivariate analysis were used to assess the effect of donor risk factors and were stratified according to recipient age. RESULTS: Overall graft survival was 91.1% (95% confidence interval [CI] 90.5-91.8) at 1 year, 88.6% (95% CI 87.8-89.4) at 2 years, and 85.6% (95% CI 84.6-86.6) at 3 years posttransplant. Univariate analysis of risk factors showed a significant reduction of graft survival in recipients transplanted with kidneys coming from donors older than 60 years, donors with a history of hypertension, a cerebrovascular cause of death, and a preharvesting serum creatinine greater than 150 micromol/L. Multivariate analysis revealed significantly higher failure rate associated with cerebrovascular cause of death (RR=1.2, P=0.02), history of hypertension (RR=1.2, P=0.04), and elevated serum creatinine (RR=1.3, P=0.03), whereas donor age greater than 60 years was not found as an independent risk factor. CONCLUSIONS: Our results suggest that cerebrovascular cause of death, history of hypertension, and elevated creatinine are significant independent donor risk factors for graft survival, whereas donor age is a statistically significant, but dependent, risk factor. This result is important for the design of allocation and transplantation strategies for kidneys procured in elderly donors.
BACKGROUND: The results of the transplantation of marginal donor kidneys remain controversial. This study aimed to investigate the impact of donor risk factors as predictors of kidney-graft outcome. METHODS: Allograft failure risk factors were studied in 7,209 cadaveric kidney-transplant recipients reporting to the Etablissement français des Greffes (EfG) from 1996 to 2000, of which 544 (7.6%) were from donors aged over 60. Both univariate and multivariate analysis were used to assess the effect of donor risk factors and were stratified according to recipient age. RESULTS: Overall graft survival was 91.1% (95% confidence interval [CI] 90.5-91.8) at 1 year, 88.6% (95% CI 87.8-89.4) at 2 years, and 85.6% (95% CI 84.6-86.6) at 3 years posttransplant. Univariate analysis of risk factors showed a significant reduction of graft survival in recipients transplanted with kidneys coming from donors older than 60 years, donors with a history of hypertension, a cerebrovascular cause of death, and a preharvesting serum creatinine greater than 150 micromol/L. Multivariate analysis revealed significantly higher failure rate associated with cerebrovascular cause of death (RR=1.2, P=0.02), history of hypertension (RR=1.2, P=0.04), and elevated serum creatinine (RR=1.3, P=0.03), whereas donor age greater than 60 years was not found as an independent risk factor. CONCLUSIONS: Our results suggest that cerebrovascular cause of death, history of hypertension, and elevated creatinine are significant independent donor risk factors for graft survival, whereas donor age is a statistically significant, but dependent, risk factor. This result is important for the design of allocation and transplantation strategies for kidneys procured in elderly donors.
Authors: María José Pérez-Sáez; Núria Montero; Dolores Redondo-Pachón; Marta Crespo; Julio Pascual Journal: Transplantation Date: 2017-04 Impact factor: 4.939
Authors: Rajesh Mohandas; Michael J Casey; Robert L Cook; Kenneth E Lamb; Xuerong Wen; Mark S Segal Journal: Clin J Am Soc Nephrol Date: 2013-10-10 Impact factor: 8.237
Authors: Dane Hoeksma; Rolando A Rebolledo; Maximilia Hottenrott; Yves S Bodar; Janneke J Wiersema-Buist; Harry Van Goor; Henri G D Leuvenink Journal: Transplantation Date: 2017-04 Impact factor: 4.939
Authors: Markus Giessing; T Florian Fuller; Frank Friedersdorff; Serdar Deger; Andreas Wille; Hans-Hellmut Neumayer; Danilo Schmidt; Klemens Budde; Lutz Liefeldt Journal: J Am Soc Nephrol Date: 2008-12-10 Impact factor: 10.121
Authors: Robert J Stratta; Michael S Rohr; Aimee K Sundberg; Greg Armstrong; Gloria Hairston; Erica Hartmann; Alan C Farney; Julie Roskopf; Samy S Iskandar; Patricia L Adams Journal: Ann Surg Date: 2004-05 Impact factor: 12.969
Authors: Mirjan M van Timmeren; Vishal S Vaidya; Rutger M van Ree; Leendert H Oterdoom; Aiko P J de Vries; Reinold O B Gans; Harry van Goor; Coen A Stegeman; Joseph V Bonventre; Stephan J L Bakker Journal: Transplantation Date: 2007-12-27 Impact factor: 4.939