Human Leucocyte Antigen-Matching Can Improve Long Term Outcome of Renal Allografts from Donors Older Than 75 Years
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Human Leucocyte Antigen-Matching Can Improve Long Term Outcome of Renal Allografts from Donors Older Than 75 Years. / Koch, Martina; Zecher, Daniel; Lopau, Kai; Weinmann-Menke, Julia; Schulze, Alicia; Nashan, Björn; Wenzel, Ulrich; Banas, Bernhard; Zeier, Martin; Thaiss, Friedrich; Sommerer, Claudia.
In: TRANSPL P, Vol. 55, No. 2, 03.2023, p. 309-316.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Human Leucocyte Antigen-Matching Can Improve Long Term Outcome of Renal Allografts from Donors Older Than 75 Years
AU - Koch, Martina
AU - Zecher, Daniel
AU - Lopau, Kai
AU - Weinmann-Menke, Julia
AU - Schulze, Alicia
AU - Nashan, Björn
AU - Wenzel, Ulrich
AU - Banas, Bernhard
AU - Zeier, Martin
AU - Thaiss, Friedrich
AU - Sommerer, Claudia
N1 - Copyright © 2023 Elsevier Inc. All rights reserved.
PY - 2023/3
Y1 - 2023/3
N2 - BACKGROUND: Renal transplantation is the therapy of choice for kidney failure. The Eurotransplant Senior Program (ESP) has been established to allocate kidneys ≥65 years to recipients of the same age group considered a regional allocation with short cold ischemia (CIT) but not human-leukocyte-antigen (HLA)-matching. The acceptance of organs aged ≥75 years is also still controversial within the ESP.METHODS: In a multicenter approach, 179 kidney grafts ≥75 years (mean donor age 78 years) that were transplanted in 174 patients in 5 German transplant centers were analyzed. The primary focus of the analysis was long-term outcome of the grafts and the impact of CIT, HLA matching, and recipient related risk factors.RESULTS: The mean graft survival was 59 months (median 67 months) with a mean donor age of 78.3 ± 2.9 years. Grafts with 0 to 3 HLA-mismatches had a significantly better overall graft survival compared to grafts with ≥4 mismatches (69 months vs 54 months; P = .008). The mean CIT was short (11.9 ± 5.3 hours) and had no impact on graft survival.CONCLUSION: Recipients receiving a kidney graft from donors aged ≥75 years can benefit from nearly 5 years of survival with a functioning graft. Even minimal HLA matching may improve long term allograft survival.
AB - BACKGROUND: Renal transplantation is the therapy of choice for kidney failure. The Eurotransplant Senior Program (ESP) has been established to allocate kidneys ≥65 years to recipients of the same age group considered a regional allocation with short cold ischemia (CIT) but not human-leukocyte-antigen (HLA)-matching. The acceptance of organs aged ≥75 years is also still controversial within the ESP.METHODS: In a multicenter approach, 179 kidney grafts ≥75 years (mean donor age 78 years) that were transplanted in 174 patients in 5 German transplant centers were analyzed. The primary focus of the analysis was long-term outcome of the grafts and the impact of CIT, HLA matching, and recipient related risk factors.RESULTS: The mean graft survival was 59 months (median 67 months) with a mean donor age of 78.3 ± 2.9 years. Grafts with 0 to 3 HLA-mismatches had a significantly better overall graft survival compared to grafts with ≥4 mismatches (69 months vs 54 months; P = .008). The mean CIT was short (11.9 ± 5.3 hours) and had no impact on graft survival.CONCLUSION: Recipients receiving a kidney graft from donors aged ≥75 years can benefit from nearly 5 years of survival with a functioning graft. Even minimal HLA matching may improve long term allograft survival.
KW - Humans
KW - Kidney Transplantation/adverse effects
KW - Kidney
KW - Transplantation, Homologous
KW - Tissue Donors
KW - Graft Survival
KW - Allografts
U2 - 10.1016/j.transproceed.2022.12.014
DO - 10.1016/j.transproceed.2022.12.014
M3 - SCORING: Journal article
C2 - 36801175
VL - 55
SP - 309
EP - 316
JO - TRANSPL P
JF - TRANSPL P
SN - 0041-1345
IS - 2
ER -
