Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors

Background: The use of kidneys from elderly controlled donation after circulatory death (cDCD) donors has increased significantly in recent years. Concerns about outcomes achieved with these elderly cDCD kidneys have arisen. We aimed to compare outcomes from elderly cDCD kidney transplant recipients...

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Autores: Buxeda, Anna, Velis, Gonzalo, Arias Cabrales, Carlos Enrique, Zapatero, Ana, Burballa Tàrrega, Carla, 1988-, Redondo Pachón, María Dolores, Mir, Marisa, Crespo Barrio, Marta, Pascual Santos, Julio, Pérez-Sáez, María José
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Recursos:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/48411
Acesso em linha:http://hdl.handle.net/10230/48411
http://dx.doi.org/10.1093/ckj/sfaa114
Access Level:acceso abierto
Palavra-chave:Brain death donors
Clinical outcomes
Donors after circulatory death
Elderly donors
Kidney transplantation
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spelling Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donorsBuxeda, AnnaVelis, GonzaloArias Cabrales, Carlos EnriqueZapatero, AnaBurballa Tàrrega, Carla, 1988-Redondo Pachón, María DoloresMir, MarisaCrespo Barrio, MartaPascual Santos, JulioPérez-Sáez, María JoséBrain death donorsClinical outcomesDonors after circulatory deathElderly donorsKidney transplantationBackground: The use of kidneys from elderly controlled donation after circulatory death (cDCD) donors has increased significantly in recent years. Concerns about outcomes achieved with these elderly cDCD kidneys have arisen. We aimed to compare outcomes from elderly cDCD kidney transplant recipients (KTrs) and elderly donation after brain death donors (DBDs) in KTrs. Methods: We conducted a single-centre retrospective study including 87 cDCD-KTrs (46 from donors ≥65 years of age and 41 from <65 years) and 126 DBD-KTrs from donors ≥65 years of age from 2013 through 2017). Young cDCD-KTrs were used as controls. The median follow-up was 27.1 months for all cDCD-KTrs and 29.7 months for DBD-KTrs ≥65 years of age. Results: Donors >65 years of age represented more than half of our global cDCD cohort (52.9%). KTs from elderly cDCDs had similar rates of delayed graft function, primary non-function and vascular complications compared with young cDCD-KTrs and elderly DBD-KTrs. Short and medium-term graft survival from elderly cDCD kidneys are excellent and are comparable to those from young cDCD and elderly DBD kidneys (90% young cDCD versus 88% elderly cDCD versus 80% elderly DBD at 36 months, P = 0.962 and 0.180, respectively). Although recipients from cDCDs ≥65 years of age showed lower 3-year patient survival (78% versus 87% in elderly DBD-KTrs; P = 0.01), recipient age was the only determinant of patient survival [hazard ratio 1.10 (95% confidence interval 1.02-1.17); P < 0.01], without any influence of donor characteristics. Conclusions: The use of kidneys from elderly cDCDs is increasing in Spain. Short- and medium-term graft outcomes are similar when comparing kidneys from elderly cDCDs and DBDs. Recipient age is the only determinant of patient survival. Additional studies are needed to assess long-term outcomes.Oxford University Press202120212020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/48411http://dx.doi.org/10.1093/ckj/sfaa114reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésClin Kidney J. 2020;14(4):1181-9© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.comhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/484112026-06-12T07:21:37Z
dc.title.none.fl_str_mv Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors
title Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors
spellingShingle Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors
Buxeda, Anna
Brain death donors
Clinical outcomes
Donors after circulatory death
Elderly donors
Kidney transplantation
title_short Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors
title_full Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors
title_fullStr Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors
title_full_unstemmed Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors
title_sort Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors
dc.creator.none.fl_str_mv Buxeda, Anna
Velis, Gonzalo
Arias Cabrales, Carlos Enrique
Zapatero, Ana
Burballa Tàrrega, Carla, 1988-
Redondo Pachón, María Dolores
Mir, Marisa
Crespo Barrio, Marta
Pascual Santos, Julio
Pérez-Sáez, María José
author Buxeda, Anna
author_facet Buxeda, Anna
Velis, Gonzalo
Arias Cabrales, Carlos Enrique
Zapatero, Ana
Burballa Tàrrega, Carla, 1988-
Redondo Pachón, María Dolores
Mir, Marisa
Crespo Barrio, Marta
Pascual Santos, Julio
Pérez-Sáez, María José
author_role author
author2 Velis, Gonzalo
Arias Cabrales, Carlos Enrique
Zapatero, Ana
Burballa Tàrrega, Carla, 1988-
Redondo Pachón, María Dolores
Mir, Marisa
Crespo Barrio, Marta
Pascual Santos, Julio
Pérez-Sáez, María José
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Brain death donors
Clinical outcomes
Donors after circulatory death
Elderly donors
Kidney transplantation
topic Brain death donors
Clinical outcomes
Donors after circulatory death
Elderly donors
Kidney transplantation
description Background: The use of kidneys from elderly controlled donation after circulatory death (cDCD) donors has increased significantly in recent years. Concerns about outcomes achieved with these elderly cDCD kidneys have arisen. We aimed to compare outcomes from elderly cDCD kidney transplant recipients (KTrs) and elderly donation after brain death donors (DBDs) in KTrs. Methods: We conducted a single-centre retrospective study including 87 cDCD-KTrs (46 from donors ≥65 years of age and 41 from <65 years) and 126 DBD-KTrs from donors ≥65 years of age from 2013 through 2017). Young cDCD-KTrs were used as controls. The median follow-up was 27.1 months for all cDCD-KTrs and 29.7 months for DBD-KTrs ≥65 years of age. Results: Donors >65 years of age represented more than half of our global cDCD cohort (52.9%). KTs from elderly cDCDs had similar rates of delayed graft function, primary non-function and vascular complications compared with young cDCD-KTrs and elderly DBD-KTrs. Short and medium-term graft survival from elderly cDCD kidneys are excellent and are comparable to those from young cDCD and elderly DBD kidneys (90% young cDCD versus 88% elderly cDCD versus 80% elderly DBD at 36 months, P = 0.962 and 0.180, respectively). Although recipients from cDCDs ≥65 years of age showed lower 3-year patient survival (78% versus 87% in elderly DBD-KTrs; P = 0.01), recipient age was the only determinant of patient survival [hazard ratio 1.10 (95% confidence interval 1.02-1.17); P < 0.01], without any influence of donor characteristics. Conclusions: The use of kidneys from elderly cDCDs is increasing in Spain. Short- and medium-term graft outcomes are similar when comparing kidneys from elderly cDCDs and DBDs. Recipient age is the only determinant of patient survival. Additional studies are needed to assess long-term outcomes.
publishDate 2020
dc.date.none.fl_str_mv 2020
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/48411
http://dx.doi.org/10.1093/ckj/sfaa114
url http://hdl.handle.net/10230/48411
http://dx.doi.org/10.1093/ckj/sfaa114
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Clin Kidney J. 2020;14(4):1181-9
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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