Session Name: Poster Session A: Kidney Deceased Donor Allocation
Date: Saturday, June 1, 2019
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall C & D
*Purpose: 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 matching.
*Methods: We performed a single center retrospective analysis in adult DD KT patients (pts). >80% of ECD kidneys were managed with machine preservation and half were imported from other donor service areas. All pts received depleting antibody induction with tacrolimus/MPA/±steroids.
*Results: Over a 13-year period, our center performed 497 ECD KTs, of which 423 occurred with a donor/recipient age difference of ≤ ±15 years (age-matched) whereas the remaining 74 occurred with an age difference > ±15 years (age-mismatched [MM]). The two groups were similar with regard to numerous characteristics (mean KDPI 82%) except that the age-MM group had fewer 0-antigen mismatches, younger recipients, more kidneys preserved with pulsatile perfusion, lower donor creatinine clearance, and more diabetic pts (all p<0.05). Mean waiting times (18 months) and cold ischemia times (mean 26 hrs) were comparable between groups. With a mean follow-up of 5 years, there were no differences in patient survival (72.6% vs 71.6% MM), death with a functioning graft (17.5% vs 18.9% MM), or delayed graft function (25.8% vs 28.4% MM) rates in the age-matched vs MM groups, respectively. However, actual graft survival ([GS] 59.1% vs 43.2% MM, p=0.015) and death-censored GS (71.6% vs 53.3% MM, p=0.006) rates were significantly higher in age-matched vs MM groups, respectively.
*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. 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.
To cite this abstract in AMA style:Harriman D, Gurram V, Farney A, Rogers J, Orlando G, Jay C, Reeves-Daniel A, Mena-Gutierrez A, Gautreaux M, Doares W, Kaczmorski S, Stratta R. Donor And Recipient Age Matching Versus Mismatching In Expanded Criteria Donor Kidney Transplants: Does It Make A Difference? [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/donor-and-recipient-age-matching-versus-mismatching-in-expanded-criteria-donor-kidney-transplants-does-it-make-a-difference/. Accessed May 9, 2021.
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