Enhanced Significance of Donor–Recipient Age Gradient as a Prognostic Factor of Graft Outcome in Living Donor Kidney Transplantation

Shin, Min Jae; Park, Jae Berm; Kwon, Choon Hyuck David; Joh, Jae‐Won; Lee, Suk-Koo; Kim, Jong Man

doi:10.1007/s00268-013-2038-1

Cited by 11 publications

(8 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Shin et al . evaluated whether the effect of donor age was different according to recipient age (≤−21, −20 to −1, 0–20, and ≥ 21 years) in kidneys from deceased donors. The authors confirmed that a negative donor‐recipient age difference (recipients receiving kidneys from a donor younger than the recipient) was associated with greater death‐censored graft survival.…”

Section: Discussionmentioning

confidence: 99%

The effect of delayed graft function on graft and patient survival in kidney transplantation: an approach using competing events analysis

et al. 2015

View full text Add to dashboard Cite

Objective: In kidney transplantation, the impact of delayed graft function (DGF) on long-term graft and patient survival is controversial. We examined the impact of DGF on graft and recipient survival by accounting for the possibility that death with graft function may act as a competing risk for allograft failure. Study design and Setting: We used data from 1281 adult primary deceaseddonor kidney recipients whose allografts functioned at least 1 year. Results: The probability of graft loss occurrence is overestimated using the complement of Kaplan-Meier estimates (1-KM). Both the cause-specific Cox proportional hazard regression model (standard Cox) and the subdistribution hazard regression model proposed by Fine and Gray showed that DGF was associated with shorter time to graft failure (csHR = 2.0, P = 0.002; sHR = 1.57, P = 0.009), independent of acute rejection (AR) and after adjusting for traditional factors associated with graft failure. Regarding patient survival, DGF was a predictor of patient death using the cause-specific Cox model (csHR = 1.57, P = 0.029) but not using the subdistribution model. Conclusions: The probability of graft loss from competing end points should not be reported with the 1-KM. Application of a regression model for subdistribution hazard showed that, independent of AR, DGF has a detrimental effect on long-term graft survival, but not on patient survival.

show abstract

Section: Discussionmentioning

confidence: 99%

The effect of delayed graft function on graft and patient survival in kidney transplantation: an approach using competing events analysis

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Shin et al 14 analyzed the DRAD and divided the patients into four groups: ≤ ‐21, ‐ 20 to – 1, 0‐20, and ≥21 years of difference between donor and recipient. A big difference was associated with more graft rejection episodes and higher serum creatinine levels beyond the first month post‐transplantation.…”

Section: Discussionmentioning

confidence: 99%

Five decades with grandparent donors: The Norwegian strategy and experience

Bjerre

Mjøen

Line

et al. 2020

Pediatric Transplantation

View full text Add to dashboard Cite

Living donors (LDs) are preferred over DDs for renal transplantation in children due to superior GS. Oslo University Hospital has never restricted living donation by upper age. The aim of this study was to investigate long‐term outcomes using grandparents (GPLD) compared to PLD. Retrospective nationwide review in the period 1970‐2017. First renal graft recipients using a GPLD were compared to PLD kidney recipients for long‐term renal function and GS. 278 children (≤18 years) received a first renal transplant: 27/251 recipients with a GPLD/PLD. GPLD (median 59 (42‐74) years) were significantly older than PLD (median 41 (23‐65) years, (P < .001). Median DRAD was 52 (38‐70) vs 28 (17‐48) years, respectively. GS from GPLD and PLD had a 1‐, 5‐, and 10‐year survival of 100%, 100%, and 90% vs 93%, 82%, and 72%, respectively (P = .6). In a multivariate Cox regression analysis adjusted for gender, donor age, recipient age, and year of transplant, this finding was similar (HR 0.98; 95% CI 0.34‐2.84, P = .97). Five‐year eGFR was 47.3 and 59.5 mL/min/1.73 m2 in the GPLD and PLD groups (P = .028), respectively. In this nationwide retrospective analysis, GS for pediatric renal recipients using GPLD was comparable to PLD. Renal function assessed as eGFR was lower in the GPLD group. The GPLD group was significantly older than the PLD group, but overall this did not impact transplant outcome. Based on these findings, older age alone should not exclude grandparent donations.

show abstract

“…La incidencia de rechazo durante el primer año reportada en esta cohorte fue inferior a lo reportado por otros estudios (18,9%), pudiendo explicar la alta tasa de supervivencia del injerto en nuestros pacientes a 5 años (88,4%) [6][7][8] .…”

Section: Discussionunclassified

Analysis of graftpost- transplant renal survival

Dávila¹,

Luna²,

Rey³

2015

Rev. Colomb. Nefrol.

View full text Add to dashboard Cite

ResumenIntroducción: Los pacientes post trasplante renal presentan una Supervivencia media inferior a la de población general, esta supervivencia se disminuye más cuando está relacionada con pérdida del injerto; se pretende identificar la contribución de los factores de riesgo con la pérdida del injerto. Materiales y métodos:Estudio de Cohorte retrospectiva post-trasplante renal; se describieron las características generales de los pacientes; se calculó el RR (Riesgo relativo) para el riesgo de pérdida del injerto (p<0,05) y se exploraron diferencias de supervivencia en diagramas de Kapplan Meier.Resultados: Se analizaron 164 casos; la mediana de edad fue de 48 años; de peso fue 68 kg, de depuración de creatinina al año del trasplante de 57,17 mg/dl; la supervivencia global del injerto a 5 años fue del 88,4% y la de los pacientes del 92,1%.El Riesgo relativo (RR) de pérdida del injerto en quienes presentaron rechazo en el primer año fue de 3,86; (p = 0,002).Se encontraron diferencias significativas en la supervivencia del injerto a cinco años en pacientes mayores vs menores de cincuenta años de edad (96,8 vs 83,2 % respectivamente), la amplitud de estas diferencias se igualó posterior a los 70 meses (5,8 años).Conclusiones: Se identificó la contribución de los factores de riesgo pretrasplante con la pérdida del injerto; encontrando a la edad como el único factor relacionado; siendo esta menor en mayores de 50 años.Según los resultados, se sugiererealizar seguimientos más estrechosa los menores de 50 años hasta el quinto año del trasplante.Palabras clave: Supervivencia libre de enfermedad, Rechazo del injerto / epidemiología, Rechazo de Injerto, Estadísticas de Atención Médica (fuente DeCS). Analysis of graftpost-transplant renal survival AbstractIntroduction:post renal transplant patients have a lower than average survival general population, this survival is decreased more when related to graft failure; It aims to identify the contribution of risk factors with graft loss.

show abstract

Enhanced Significance of Donor–Recipient Age Gradient as a Prognostic Factor of Graft Outcome in Living Donor Kidney Transplantation

Abstract: This study demonstrated that DRAG may serve as a prognostic factor for predicting graft outcomes after LDKT. Additionally, we showed that transplantation of older donor kidneys via living donation is justified in appropriately chosen age-matched recipients.

Cited by 11 publications

References 61 publications

The effect of delayed graft function on graft and patient survival in kidney transplantation: an approach using competing events analysis

The effect of delayed graft function on graft and patient survival in kidney transplantation: an approach using competing events analysis

Five decades with grandparent donors: The Norwegian strategy and experience

Analysis of graftpost- transplant renal survival

Contact Info

Product

Resources

About