BACKGROUND: The Eurotransplant Senior Program (ESP) was launched in 1999, targeted to increase the supply of donor kidneys to the elderly. This program requires local allocation of kidneys from cadaveric donors >>65 years to recipients >>65 years. METHODS: Of all patients >>65 years who received a kidney transplant in 1999-2002 at our center, 59 patients were transplanted through the ESP protocol (ESP group), and 44 patients received a transplant from a younger donor (EuroTransplant Kidney Allocation System, ETKAS group). Recipients were followed for up to 5.3 years using the Austrian Dialysis and Transplant Registry. Outcomes studied included all-cause mortality and allograft loss. RESULTS: Age, sex, and comorbid conditions did not differ by group. Donor age was higher (69 vs. 36 years; P < 0.001) and cold ischemia time shorter in the ESP group (10 vs. 15 hr; P < 0.001). Number of HLA mismatches was greater in the ESP group (3.8 vs. 3.0; P = 0.003). ESP patients were more likely to receive induction therapy and less likely to receive cyclosporine A. Primary nonfunction, delayed graft function, operative mortality, rate of acute rejection episodes, and length of stay did not differ by group. Although serum creatinine at discharge was higher in ESP patients (1.7 vs. 1.4 mg/dL; P < 0.001), 4-year mortality (hazard ratio [HR] = 0.68; 95% CI: 0.31-1.49) and graft loss (HR = 0.61; 95% CI: 0.29-1.28) tended to be less. CONCLUSIONS: Long-term patient and graft survival were comparable between elderly patients who received their organ via the ESP and the regular ETKAS algorithm.
BACKGROUND: The Eurotransplant Senior Program (ESP) was launched in 1999, targeted to increase the supply of donor kidneys to the elderly. This program requires local allocation of kidneys from cadaveric donors >>65 years to recipients >>65 years. METHODS: Of all patients >>65 years who received a kidney transplant in 1999-2002 at our center, 59 patients were transplanted through the ESP protocol (ESP group), and 44 patients received a transplant from a younger donor (EuroTransplant Kidney Allocation System, ETKAS group). Recipients were followed for up to 5.3 years using the Austrian Dialysis and Transplant Registry. Outcomes studied included all-cause mortality and allograft loss. RESULTS: Age, sex, and comorbid conditions did not differ by group. Donor age was higher (69 vs. 36 years; P < 0.001) and cold ischemia time shorter in the ESP group (10 vs. 15 hr; P < 0.001). Number of HLA mismatches was greater in the ESP group (3.8 vs. 3.0; P = 0.003). ESP patients were more likely to receive induction therapy and less likely to receive cyclosporine A. Primary nonfunction, delayed graft function, operative mortality, rate of acute rejection episodes, and length of stay did not differ by group. Although serum creatinine at discharge was higher in ESP patients (1.7 vs. 1.4 mg/dL; P < 0.001), 4-year mortality (hazard ratio [HR] = 0.68; 95% CI: 0.31-1.49) and graft loss (HR = 0.61; 95% CI: 0.29-1.28) tended to be less. CONCLUSIONS: Long-term patient and graft survival were comparable between elderly patients who received their organ via the ESP and the regular ETKAS algorithm.
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: Kelly L Stolzmann; Leonelo E Bautista; Ronald E Gangnon; Jane A McElroy; Bryan N Becker; Patrick L Remington Journal: J Natl Med Assoc Date: 2007-08 Impact factor: 1.798
Authors: Erzsi Tegzess; Antonio W Gomes Neto; Robert A Pol; Silke E de Boer; Hessel Peters-Sengers; Jan-Stephan F Sanders; Stefan P Berger Journal: Transpl Int Date: 2021-10-28 Impact factor: 3.842
Authors: Jose Maria Morales; Roberto Marcén; Domingo del Castillo; Amado Andres; Miguel Gonzalez-Molina; Federico Oppenheimer; Daniel Serón; Salvador Gil-Vernet; Ildefonso Lampreave; Francisco Javier Gainza; Francisco Valdés; Mercedes Cabello; Fernando Anaya; Fernando Escuin; Manuel Arias; Luis Pallardó; Jesus Bustamante Journal: Nephrol Dial Transplant Date: 2012-12 Impact factor: 5.992