Analysis of factors that affect outcome of primary cadaveric renal transplantation in the UK

Morris, Peter J.; Rj, Johnson; Fuggle, Susan V.; Belger, Mark; Briggs, J. D.

doi:10.1016/s0140-6736(99)01104-6

Cited by 223 publications

(53 citation statements)

References 14 publications

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“…These ''ECD'' kidneys are from donors over the age of 60 years without comorbidities or donors over the age of 50 years with two co-morbidities from amongst hypertension, death from cerebrovascular accident, or terminal serum creatinine levels [1.5 mg/dl [9] (Table 1). ECD may have a greater risk of delayed graft function (DGF), primary non-function, and shortened graft survival because of co-morbidities, such as obesity, hypertension, or cardiovascular disease associated with the donor kidney [10][11][12]. The value of kidneys meeting these expanded criteria was questioned due to concerns over diminished graft survival and poorer outcomes [10,13,14].…”

Section: Expanded Criteria Donor (Ecd) Kidneysmentioning

confidence: 99%

Renal transplantation in the elderly

Saxena

Yu²,

Giraldo

et al. 2008

Int Urol Nephrol

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Elderly patients are increasingly being considered for kidney transplantation due to a global explosion of the aging population with end-stage renal disease (ESRD). However, mounting scarcity of available organs for transplant has led to a wider disparity between organ supply and demand. Consequently, the criteria for accepting kidneys for transplantation have been extended in an attempt to allow the use of organs from elderly donors or those with significant co-morbidities, so-called "expanded criteria donor" (ECD) kidneys. Excellent outcomes have been achieved from ECD kidneys with appropriate donor and recipient profiling and selection. With increasing recovery efforts directed at older donors, the concept of age-matching is becoming more accepted as a method of optimizing utilization of organs in elderly donors and recipients. Utilization of pulsatile perfusion has further improved ECD outcomes and helped the decision-making process for the UNOS (United Network for Organ Sharing) offer. However, age-related immune dysfunction and associated co-morbidities make the elderly transplant recipients ever more susceptible to complications associated with immunosuppressive agents. Consequently, the elderly population is at a higher risk to develop infections and malignancy in the post-transplant period notwithstanding improved transplant outcomes. Appropriate immunosuppressive agents and dosages should be selected to minimize adverse events while reducing the risk of acute rejections and maximizing patient and renal allograft survival.

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Section: Expanded Criteria Donor (Ecd) Kidneysmentioning

confidence: 99%

Renal transplantation in the elderly

Saxena

Yu²,

Giraldo

et al. 2008

Int Urol Nephrol

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“…In general, it can be stated that donor organ allocations in many countries are based on medical and patient- oriented criteria [6,7]. However, it should be added that other organizational and logistical factors sometimes also have significant roles to play in the final allocation.…”

Section: Resultsmentioning

confidence: 99%

Allocation of Organs, Particularly Kidneys, Within Eurotransplant

Persijn¹

2006

Human Immunology

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“…Den wahrscheinlich größten Einfluß auf den längerfristigen Transplantationserfolg hat das Alter des Spenders [8]. Bei einem Spenderalter von über 60 Jahren und unter sechs Jahren beobachtet man vermehrt ein frühzeitiges Transplantatversagen.…”

Section: Spende-/spenderabhängige Nicht-immunologische Risikofaktorenunclassified

“…Jüngste Untersuchungen konnten bestätigen, daß bei HLA-Identität oder guter Übereinstim-mung nicht nur das kurzfristige Transplantatüberleben und die Häufigkeit von akuten Abstoßungen positiv beeinflußt werden, sondern auch die langfristigen Erfolge [8]. Die vollständige Übereinstimmung der HLA-A-, -B-und -DR-Loci zwischen Spender und Empfänger (sogenannte "Full-house"-Konstellation) geht eindeutig mit der besten Fünf-Jahres-Transplantatüberlebenszeit einher.…”

Section: Immunologische Risikofaktorenunclassified

Langzeitprobleme bei nierentransplantierten Patienten

Heidenreich

August²,

Lang

2000

Med Klin

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Allogenic kidney transplantation is a widely established treatment option for patients with end-stage renal disease to gain independency from dialysis and recovery of excretory and hormonal functions. Transplantation is superior to dialysis with respect to quality of life, morbidity and mortality. Improvements in one-year graft survival have become evident during the last decades, but long-term outcome is not yet satisfying. The most common form of late transplant failure is chronic rejection or chronic allograft nephropathy, and as a consequence of higher ages of transplant recipients death of patients with functioning grafts. The histological hallmark of chronic rejection is intimal thickening of small arteries and arterioles, but the involved pathomechanisms are not well understood. Strict normalization of blood pressure and hyperlipidemia by drugs aims to prevent vascular alterations of chronic allograft nephropathy. In addition, in this overview some other late complications of renal transplant recipients are addressed which are associated to chronic immunosuppression, such as viral or malignant diseases.

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Analysis of factors that affect outcome of primary cadaveric renal transplantation in the UK

Cited by 223 publications

References 14 publications

Renal transplantation in the elderly

Renal transplantation in the elderly

Allocation of Organs, Particularly Kidneys, Within Eurotransplant

Langzeitprobleme bei nierentransplantierten Patienten

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