The combined risk of donor quality and recipient age: higher-quality kidneys may not always improve patient and graft survival.
Roland A. Hernandez,Sayeed K. Malek,Edgar L. Milford,Samuel R.G. Finlayson,Stefan G. Tullius +4 more
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TLDR
It is demonstrated that transplanting medium-quality kidneys into elderly recipients does not provide significant advantage over low-quality kidney transplants, and Cox proportional hazards was used to assess graft and recipient survival.Abstract:
Background
The Kidney Donor Profile Index (KDPI) is a more precise donor organ quality metric replacing age-based characterization of donor risk. Little prior attention has been paid on the outcomes of lower quality kidneys transplanted into elderly recipients. Although we have previously shown that immunological risks associated with older organs are attenuated by advanced recipient age it remains unknown whether risks associated with lower quality KDPI organs are similarly reduced in older recipients.read more
Citations
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Journal ArticleDOI
Improving the Supply and Quality of Deceased-Donor Organs for Transplantation
Stefan G. Tullius,Hamid Rabb +1 more
TL;DR: The supply and quality of Deceased-Donor Organs and Solid-organ transplantation is the treatment of choice for many patients with end-stage diseases, but the supply is limited.
Journal ArticleDOI
Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal Disease: A Literature Review and Position Statement on Behalf of the European Renal Association-European Dialysis and Transplant Association Descartes Working Group and European Renal Best Practice.
Liviu Segall,Ionuţ Nistor,Julio Pascual,Istvan Mucsi,Lluis Guirado,Robert Higgins,Steven Van Laecke,Rainer Oberbauer,Wim Van Biesen,Daniel Abramowicz,Cristina Gavrilovici,Ken Farrington,Adrian Covic +12 more
TL;DR: Evidence for the benefits and risks of RT in the elderly in elderly patients is looked at to answer the following questions: Should RT be advocated for elderly patients, and what should be the criteria to accept elderly patients on the waiting list for RT.
Journal ArticleDOI
Strategies for an Expanded Use of Kidneys From Elderly Donors.
TL;DR: Survival and functional outcomes achieved with expanded criteria donor, high Kidney Donor Profile Index or advanced age kidneys are poorer than those with standard ones.
Journal ArticleDOI
Is the Kidney Donor Risk Index a step forward in the assessment of deceased donor kidney quality
TL;DR: The KDRI should provide us with a robust qualitative evaluation of deceased donor quality, and therefore will probably play a role in deceased donor kidney allocation policies across Europe in the near future.
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Validation of the Prognostic Kidney Donor Risk Index Scoring System of Deceased Donors for Renal Transplantation in the Netherlands
Hessel Peters-Sengers,Martin B A Heemskerk,Ronald B. Geskus,Ronald B. Geskus,Jesper Kers,Jaap J. Homan van der Heide,Stefan P Berger,Frederike J. Bemelman +7 more
TL;DR: The KDRI performs equal in the Dutch population and indicates limited clinical use for adequate individualized decisions, and an updated KDRI may contribute to a standardized policy meeting the growing demand of donor kidneys in the Eurotransplant region.
References
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Journal ArticleDOI
Comparison of Mortality in All Patients on Dialysis, Patients on Dialysis Awaiting Transplantation, and Recipients of a First Cadaveric Transplant
Robert A. Wolfe,Valarie B. Ashby,Edgar L. Milford,Akinlolu O. Ojo,Robert E. Ettenger,Lawrence Y. Agodoa,Philip J. Held,Friedrich K. Port +7 more
TL;DR: In this paper, the authors conducted a longitudinal study of mortality in 228,552 patients who were receiving long-term dialysis for end-stage renal disease, and 46,164 were placed on a waiting list for transplantation, 23,275 of whom received a first cadaveric transplant between 1991 and 1997.
Journal ArticleDOI
A comprehensive risk quantification score for deceased donor kidneys: the kidney donor risk index.
Panduranga S. Rao,Douglas E. Schaubel,Mary K. Guidinger,Kenneth A. Andreoni,Robert A. Wolfe,Robert M. Merion,Friedrich K. Port,Randall S. Sung +7 more
TL;DR: The graded impact of KDRI on graft outcome makes it a useful decision-making tool at the time of the deceased donor kidney offer, and it is likely that there is a considerable overlap in the KDRI distribution by expanded and nonexpanded criteria donor classification.
Journal ArticleDOI
Expanded criteria donors for kidney transplantation.
Robert A. Metzger,Francis L. Delmonico,Sandy Feng,Friedrich K. Port,James J. Wynn,Robert M. Merion +5 more
TL;DR: A large number of patients with prior organ transplants are likely to have had at least one prior organ transplant, and the results suggest that the number of previous transplants may have an important role in determining the prognosis.
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Renal transplantation in elderly patients older than 70 years of age: results from the Scientific Registry of Transplant Recipients.
Panduranga S. Rao,Robert M. Merion,Valarie B. Ashby,Friedrich K. Port,Robert A. Wolfe,Liise K. Kayler +5 more
TL;DR: Transplantation offers a significant reduction in mortality compared with dialysis in the wait-listed elderly population with end-stage renal disease in the United States.
Journal ArticleDOI
Expanded criteria donors for kidney transplantation.
TL;DR: The impact of ECD kidney transplantation on mortality risk among candidates awaiting deceased donor renal transplantation is examined and the effects of these policy changes in the United States have been studied recently.