Date: Sunday, June 12, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Introduction: An increasing number of marginal donors are being used in order to expand the donor pool. Age is one of the major criteria in defining 'extended criteria'. In terms of allograft life-years, aged match kidneys ie old donors to old recipients may be highly appropriate, however in younger patients, receiving a kidney from an older donor may result in premature graft failure and the risk of requiring retransplantation, this compounds the waitlist number and on an individual level makes allocation more difficult in the setting of sensitisation from the failed allograft.
Methods: The aim of this study is to determine the allograft outcomes of young recipients (YR) receiving a transplant from an old (OD) versus a young (YD) deceased donor. 60 years old was defined as old in both donors and recipients.
Results: 417 YD (Mean age: 42.2±13.1) were transplanted into YR (Mean age: 43.6±10.5); 115 OD (66.4±4.3) were transplanted into YR (50.6±7.8). Mean follow up is 4.67 ±2.20. Allograft outcomes are shown below.
|Event||HR (95% CI) Old v young donors in young recipients||p value|
|Patient survival||2.14 (1.01-4.51)||0.015|
|All graft loss (GL)||2.65 (1.43-4.93)||0.0001|
|DWFG(death with functioning graft)||2.46 (0.95-6.41)||0.018|
|Death censored GL||2.60 (1.54-4.36)||0.0001|
|Rejection free survival||0.58 (0.38-0.89)||0.033|
Mean eGFR at 1 year and 5 years in the YD to YR group was 57.0(44.7-73.24) and 53.22(39.6-67.5) compared with 40.8(32.7-53.6), p<0.0001 and 38.6(25.1-60.5), p=0.01 in the OD to YR groups. A further analysis showed no difference in all GL [HR: 0.90(0.6-1.5), p=0.69], DWFG [HR: 1.67(0.8-3.7), p=0.20), death censored allograft survival [HR: 0.59(0.3-1.1), p=0.12) and rejection [HR: 1.23(0.6-2.4), p=0.54) in YD into OR when compared with OD into YR pairs
Discussion: Donor organ quality needs to be taken into consideration during the acceptance and informed consent process for young recipients who are more likely to require a functioning allograft for a longer period than older recipients.
CITATION INFORMATION: Wardle A, Willicombe M, Goodall D, McLean A, Taube D. Young Recipients Receiving Kidneys from Older Donors Have Poorer Allograft Outcomes. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Wardle A, Willicombe M, Goodall D, McLean A, Taube D. Young Recipients Receiving Kidneys from Older Donors Have Poorer Allograft Outcomes. [abstract]. Am J Transplant. 2016; 16 (suppl 3). http://atcmeetingabstracts.com/abstract/young-recipients-receiving-kidneys-from-older-donors-have-poorer-allograft-outcomes/. Accessed January 16, 2018.
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