Outcomes after Kidney Transplant (KTx) from Deceased Donors (DD) Aged ≥ 70
Mayo Clinic, Phoenix.
Meeting: 2018 American Transplant Congress
Abstract number: D116
Session Information
Session Name: Poster Session D: Kidney Donor Selection / Management Issues
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background:
There has been an increase in DD aged 70 or greater and transplant centers are reluctant to accept these organs. The aim of this study is to determine the outcomes with KTx from DD ≥ 70 years old.
Methods:
We included all KTx from DD at our center between 2003 and 6/2017. The comparison group is DD less than 70 years of age. The primary outcome was graft survival which included death with function.
Results:
A total of 1554 KTx were analyzed: 3.4% (N=53) donors aged ≥ 70 and 96.6% < 70 (N=1501). The recipients in the donor group ≥ 70 were older. The donors in this group had lower terminal creatinine and were less likely to be DCD donors suggesting careful selection. As expected, there were more chronic changes on reperfusion biopsies in the older donor group.
| Table 1 – Donor and Recipient characteristics | |||
| Donor ≥ 70 (n=53) | Donor < 70 (n=1501) | p value | |
| Recipient age | 69.3 | 55.8 | <0.0001 |
| KDPI | 96 | 51 | <0.0001 |
| Donor terminal Cr | 1.04 (0.37) | 2.19 (2.4) | 0.0004 |
| DCD | 0 | 15.3 | <0.0001 |
| Reperfusion biopsy: | |||
| %ci>0 | 43.2 | 19.9 | 0.0017 |
| %ct>0 | 54 | 32 | 0.007 |
| %cv>0 | 73 | 55.1 | 0.0277 |
| %ah>0 | 27 | 14.2 | 0.0480 |
There was no difference in incidence of DGF. The eGFR at one year was inferior in the donor group ≥ 70. The % of patients with 1 year eGFR < 30 was higher in the donor group ≥ 70. Graft survival was not significantly different in the group with donors ≥ 70.
| Table 2 – Outcomes | |||
| Donor ≥ 70 | Donor < 70 | p value | |
| eGFR @ 1 yr | 46.1 (18.9) | 58.0 (21.2) | 0.0008 |
| eGFR<30 @ 1 yr | 24.3% | 7.2% | 0.0017 |
| 1 year Bx cv>0 | 73.3 | 45.5 | 0.0023 |
| 1 year Graft survival | 92.0 (n=44) | 94.2 (n=1321) | 0.3158 |
| 3 year Graft survival | 92.0 (n=32) | 87.4 (n=798) | |
Conclusion:
Kidneys from selected donors age ≥ 70 can be used successfully with good outcomes. There may be an opportunity to expand the donor pool utilizing such donors.
CITATION INFORMATION: Srinivasan A., Heilman R., Khamash H., Reddy K., Moss A. Outcomes after Kidney Transplant (KTx) from Deceased Donors (DD) Aged ≥ 70 Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Srinivasan A, Heilman R, Khamash H, Reddy K, Moss A. Outcomes after Kidney Transplant (KTx) from Deceased Donors (DD) Aged ≥ 70 [abstract]. https://atcmeetingabstracts.com/abstract/outcomes-after-kidney-transplant-ktx-from-deceased-donors-dd-aged-70/. Accessed November 23, 2024.« Back to 2018 American Transplant Congress