Donor age and delayed graft function as predictors of renal allograft survival in rejection-free patients

Moreso, Francesc; Serón, Daniel; Gil-Vernet, S.; Riera, Lluı́s; Fulladosa, Xavier; Ramos, Rosa; Alsina, J; Grinyó, Josep M.

doi:10.1093/ndt/14.4.930

Cited by 166 publications

(126 citation statements)

References 4 publications

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“…This result could be anticipated taking into consideration that DGF is associated with an increased recruitment of inflammatory cells and an increased risk for the development of acute rejection (32,33). Even in rejection-free patients, DGF is an independent risk factor for late graft failure owing to CAN (34).…”

Section: Progression Of Chronic Allograft Nephropathymentioning

confidence: 98%

Serial Protocol Biopsies to Quantify the Progression of Chronic Transplant Nephropathy in Stable Renal Allografts

Moreso

López

Vallejos

et al. 2001

American Journal of Transplantation

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Aim: To evaluate the utility of intimal thickness and interstitial width as a primary efficacy variable in the design of clinical trials aimed to modify the natural history of chronic allograft nephropathy. Methods: A donor and a 4-month protocol biopsy were evaluated in 40 stable grafts according to the Banff schema. In 27 patients, a second protocol biopsy was done at 1 yr. Arterial intimal volume fraction (Vvintima/ artery) and cortical interstitial volume fraction (Vvinterstitium/cortex) were estimated with a point counting technique. Results: Chronic Banff scores increased during followup, while acute scores reached its peak at 4 months. Vvintima/artery and Vvinterstitium/cortex significantly increased at 4 months, but not at 1 yr. Vvintima/artery at 4 months correlated with donor Vvintima/artery (r Ω0.57, p ∞0.001), histocompatibility (r Ω0.38, p Ω 0.01) and serum cholesterol (r Ω0.31, p Ω0.047). Vvinterstitium/cortex at 4 months correlated with recipient body surface area (r Ω0.44, p Ω0.004) and delayed graft function (p Ω0.016). Power calculations showed that Vvintima/artery and Vvinterstitium/cortex allow an important reduction in minimum sample size of a hypothetical trial aimed to prevent chronic allograft nephropathy. Conclusions: Intimal thickening and interstitial widening progresses rapidly during the first 4 months after transplantation and slowly thereafter. These parameters can be considered as a primary efficacy variable in trials aimed to prevent chronic allograft nephropathy.

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Section: Progression Of Chronic Allograft Nephropathymentioning

confidence: 98%

Serial Protocol Biopsies to Quantify the Progression of Chronic Transplant Nephropathy in Stable Renal Allografts

Moreso

López

Vallejos

et al. 2001

American Journal of Transplantation

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“…Nevertheless, the allocation of organs from older donors to older recipients is currently the chosen strategy of the Eurotransplant Senior Program [20]. Our data, as well as a recently published report [17] indicate that in view of the unclear long-term prognosis of these grafts, at least the additional risk factor of DGF and in turn, long cold ischemic times, should be avoided as far as possible. The Eurotransplant Program addresses this particular point with its recommendation that the cold ischemic time be less than 8 h. Although the initial results indicate an acceptable short-term prognosis of the patients receiving transplants in the context of the Senior Program [24], more extensive figures are required before such a policy can, in our opinion, be generally recommended.…”

Section: Discussionmentioning

confidence: 60%

“…Several definitions of DGF are applied in the current literature, thus influencing the reported incidences. Many studies define DGF as the need for any or more than one dialysis session in a specified postoperative period [12,16,17,25, 261, a definition that is easy to apply especially for aquisition of data in large registries. However, there are undoubtedly forms of early impairment of allograft function that do not require postoperative dialysis.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for delayed graft function after renal transplantation and their significance for long-term clinical outcome

Hetzel¹,

Klein²,

Brause³

et al. 2002

Transplant International

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“…Tekintettel arra, hogy a KDPI egyik legfontosabb összetevője a donor életkora, ez az allokációs gyakorlat összhangban van az Eurotransplant Senior Programjával, amely során a 65 évnél idősebb donorok veséjét 65 évnél idősebb, nem immunizált (PRA<5%) recipienseknek ajánlják fel, előze-tesen nem figyelembe véve a HLA-egyezést [11,12], előnyben részesítve az alacsony CIT-időt. Az idősebb vesék ugyanis érzékenyebbek az ischaemiás-reperfúziós károsodásra, ennek következtében gyakrabban lép fel delayed graft function, ami a vesetúlélést is negatívan befolyásolja [13,14]. Az ET Senior Program eddigi eredmé-nyeit megerősíti az a tény, hogy ebben a csoportban a 3 éves grafttúlélés (a beteg halála miatti graftvesztés kizárá-sával) nem különbözött a hagyományos HLA-egyezésen alapuló allokációs rendszerben észlelttől [15].…”

Section: áBra 1-3 éVes Grafttúlélés Az Ecd/scd Illetve Dds-csoportokbanunclassified

Donorszelekciós kritériumok vizsgálata a debreceni veseátültetési programban

et al. 2016

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Bevezetés: A donorszervhiány, a donorok életkorának növekedése és a társbetegségek gyakoribbá válása arra ösztönzi a transzplantálóközpontokat, hogy olyan donorvesék elfogadását is mérlegeljék, amelyeket korábban elutasítottak volna. A donorszelekciós kritériumok segíthetnek ennek eldöntésében. Célkitűzés: A különböző kritériumok hasznosságát illetően nincs egységes álláspont, ezért a szerzők megvizsgálták az expanded criteria donor, a deceased donor score és a kidney donor risk index donorszelekciós kritériumok hatását a posztoperatív vesefunkcióra és grafttúlélésre. Módszer: Ötéves intervallumban 205 donor paramétereinek és 138 veseátültetés kimenetelének retrospektív elemzé-sét végezték el. Eredmények: Az expanded criteria donor rendszer szerint optimálisnak véleményezett donorok negyede a magas kockázatú csoportba került a deceased donor score alapján. A magas kockázatú csoportokban rosszabb volt a műtét utáni graftfunkció. A deceased donor score segítségével tovább lehetett bontani a magas kockázatú csoportot. Az így létrejött legmagasabb kockázatú csoport grafttúlélése és műtét utáni graftműködése elmaradt a többi csoportéhoz képest. Következtetések: A vizsgált pontrendszerek segíthetnek a donorpool biztonságos növelé-sében. Orv. Hetil., 2016, 157(24), 946-955. Kulcsszavak: veseátültetés, kiterjesztett donorkritériumok, kimenetel, marginális donor Analysis of donor scoring systems in a single Hungarian transplant centreIntroduction: To ease organ shortage many transplant centres developed different donor scoring systems, however, a general consensus among clinicians on the use of these systems does not still exist. Aim: The aim of the authors was to analyse the effect of expanded criteria donor, deceased donor score and kidney donor risk index on postoperative kidney function and graft survival. Method: Analysis of the characteristics of 138 kidney transplantations and 205 donors in a retrospective study of a five-year period. Results: There was a trend towards rejecting donors in higher risk groups; 22.7% of standard criteria donors belonged to the high risk group of deceased donor score. Graft function was worse in high risk patients. High risk donors can be divided due to the use of deceased donor score. Patients with the highest risk had worse graft function and survival. Conclusions: With the use of these scoring systems grafts with favourable outcome can be selected more precisely.

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Donor age and delayed graft function as predictors of renal allograft survival in rejection-free patients

Abstract: Regardless of the presence of acute rejection, delayed graft function amplifies the detrimental effect of advanced donor age on long-term graft outcome.

Cited by 166 publications

References 4 publications

Serial Protocol Biopsies to Quantify the Progression of Chronic Transplant Nephropathy in Stable Renal Allografts

Serial Protocol Biopsies to Quantify the Progression of Chronic Transplant Nephropathy in Stable Renal Allografts

Risk factors for delayed graft function after renal transplantation and their significance for long-term clinical outcome

Donorszelekciós kritériumok vizsgálata a debreceni veseátültetési programban

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