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Titre du document / Document title

Significance of the donor age effect on kidney transplants

Auteur(s) / Author(s)

TERASAKI P. I. (1) ; GJERTSON D. W. (1) ; CECKA J. M. (1) ; TAKEMOTO S. (1) ; YONG WON CHO (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) UCLA Medical School, Department of Surgery, Los Angeles, ETATS-UNIS

Résumé / Abstract

The shortage of cadaveric donor kidneys for transplantation has forced a re-evaluation of the limits on donor age acceptability. However, as more kidneys from older donors have been transplanted, a significantly lower graft survival has been noted among their recipients. The impact of utilizing older donor kidneys and the relative importance of donor age with respect to other factors has not been clarified. A total of 43172 cadaver donor transplants reported to the UNOS Scientific Renal Transplant Registry between 1987 and 1995 were the subjects of this study. Cox regression analysis was utilized to assess the joint effects on graft survival of donor age and HLA mismatch, recipient sex, race, age, original disease, donor death cause, cold ischemia time, and transplant year. Increased first day anuria, dialysis requirement, and discharge serum creatinine were noted with increasing donor age. Moreover, long-term graft and patient survival diminished as donor age increased. The 5-yr graft survival of zero HLA-A,B,DR mismatched kidneys fell steadily from 81% when the donor was aged 21-30 to 39% when the donor was over age 60. The reported causes of kidney transplant failure were remarkably similar for old and young donors. The best transplant results were obtained with zero HLA-A,B,DR mismatched transplants from young donors and the worst with older donor kidneys, regardless of HLA compatibility. We calculated that up to 21% of kidney failures resulted from insufficient renal mass due to age and were incorrectly attributed to chronic rejection.

Revue / Journal Title

Clinical transplantation    ISSN  0902-0063 

Source / Source

1997, vol. 11 (1), no5, pp. 366-372 (19 ref.)

Langue / Language

Anglais

Editeur / Publisher

Wiley, Hoboken, NJ, ETATS-UNIS  (1987) (Revue)

Mots-clés anglais / English Keywords

Transplantation

;

Kidney

;

Human

;

Age criterion

;

Donor

;

Correlation

;

Complication

;

Postoperative

;

Glomerular filtration

;

Renal function

;

Compatibility

;

Histocompatibility system

;

Cadaver

;

Surgery

;

Kidney disease

;

Urinary system disease

;

Mots-clés français / French Keywords

Transplantation

;

Rein

;

Homme

;

Critère âge

;

Donneur

;

Corrélation

;

Complication

;

Postopératoire

;

Filtration glomérulaire

;

Fonction rénale

;

Compatibilité

;

Système histocompatibilité

;

Cadavre

;

Chirurgie

;

Rein pathologie

;

Appareil urinaire pathologie

;

Mots-clés espagnols / Spanish Keywords

Trasplantación

;

Riñón

;

Hombre

;

Criterio edad

;

Donador

;

Correlación

;

Complicación

;

Postoperatorio

;

Filtración glomerular

;

Función renal

;

Compatibilidad

;

Sistema histocompatibilidad

;

Cadáver

;

Cirugía

;

Riñón patología

;

Aparato urinario patología

;

Localisation / Location

INIST-CNRS, Cote INIST : 21313, 35400006861620.0050

Nº notice refdoc (ud4) : 2848732



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