Does Donor and Recipient Age Disparity Make a Difference with Expanded Criteria Donors?

M. Khan,¹ K. Jones,¹ H. El-Hennawy,¹ A. Farney,¹ J. Rogers,¹ G. Orlando,¹ A. Reeves-Daniel,² A. Palanisamy,² M. Gautreaux,³ S. Iskandar,³ W. Doares,⁴ S. Kaczmorski,⁴ R. Stratta.¹

¹Surgery, Wake Forest, Winston-Salem, NC
²Internal Medicine, Wake Forest, Winston-Salem, NC
³Pathology, Wake Forest, Winston-Salem, NC
⁴Pharmacy, Wake Forest, Winston-Salem, NC.

Meeting: 2016 American Transplant Congress

Abstract number: C77

Keywords: Allocation, Donors, Graft survival, Kidney transplantation, marginal

Session Information

Session Name: Poster Session C: Economics, Public Policy, Allocation, Ethics

Session Type: Poster Session

Date: Monday, June 13, 2016

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

The critical shortage of donor organs challenges the transplant community to optimize the use of organs from all consented deceased donors (DD). The purpose of this study was to review our experience with expanded criteria donor (ECD) kidney transplants (KT) with respect to donor and recipient age differences. Methods: We performed a single center retrospective analysis in adult DD KT patients (pts). >80% of ECD kidneys were managed with machine preservation. All pts received depleting antibody induction with FK/mycophenolate. Delayed graft function (DGF) was defined as the need for hemodialysis for any reason in the 1st week following transplant. Results: From 10/01 to 7/14, our center performed 497 ECD KTs, of which 423 occurred with a donor/recipient age disparity of ≤15 years (age-matched) whereas the remaining 74 occurred with an age disparity >15 years (age-mismatched). With a mean follow-up of 62 months (minimum 1 year), there were no differences in patient survival (72.6% vs 71.6%), death with a functioning graft (17.5% vs 18.9%), or DGF (25.8% vs 28.4%) rates in the age-matched vs mismatched groups, respectively. However, actual graft survival (GS, 59.1% vs 43.2%, p=0.015) and death-censored graft survival (DCGS, 71.6% vs 53.3%, p=0.006) rates were significantly higher in age-matched vs mismatched groups, respectively. We next analyzed ECD KT outcomes according to distinct recipient age categories (40-59, 60-69, and ≥70); kidney GS and DCGS rates improved (p<0.05) with increasing recipient age category. Conclusions: The new Kidney Allocation System attempts to eliminate extreme age mismatches between donor and recipient in order to match graft lifespan with recipient life expectancy. In addition, however, the above findings suggest that the optimal use of an ECD kidney is to match donor and recipient age in order to improve graft survival rates.

CITATION INFORMATION: Khan M, Jones K, El-Hennawy H, Farney A, Rogers J, Orlando G, Reeves-Daniel A, Palanisamy A, Gautreaux M, Iskandar S, Doares W, Kaczmorski S, Stratta R. Does Donor and Recipient Age Disparity Make a Difference with Expanded Criteria Donors? Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Khan M, Jones K, El-Hennawy H, Farney A, Rogers J, Orlando G, Reeves-Daniel A, Palanisamy A, Gautreaux M, Iskandar S, Doares W, Kaczmorski S, Stratta R. Does Donor and Recipient Age Disparity Make a Difference with Expanded Criteria Donors? [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/does-donor-and-recipient-age-disparity-make-a-difference-with-expanded-criteria-donors/. Accessed November 22, 2024.

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