Session Name: Poster Session D: Non-Organ Specific: Economics & Ethics
Session Type: Poster Session
Date: Tuesday, June 4, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: We investigated the occurrence of deceased-donor liver (DDOLT), deceased-donor renal (DDRT), and living-donor renal allografts (LDRT) that have achieved 100 years or more of physiologic function.
*Methods: All adult single-organ, DDOLT (n=126,289), DDRT (n=259,153), and LDRT (n=135,316) reported to UNOS/OPTN database from 10/87 to 06/18 were evaluated. LDOLT were not considered due to the relative novelity of this procedure. Allograft survival was calculated according to the equation: Allograft Survival = Allograft Age at Donation + Graft Survival and categorized as 90 – 94 years, 95-99 years, or 100 years and longer. Graft survival was defined as function time to date of most recent follow-up or death, re-listing for transplant, or for kidney transplants (txs) initiation of renal replacment therapy. Multivariate analysis assessed predictors for physiologic allograft survival.
*Results: For DDOLT recipients, the Kaplan Meier estimate for allograft survival to achieve at least 90 years of function reached 8.9%. Those were 296 DDOLT which demonstrated physiologic function in excess of 90 years. This includes 246 DDOLT txs with allograft survival of 90 -94 years 41 DDOLT txs 95-99 years, and 9 DDOLT txs 100 years or longer (maximum: 104 years). The Kaplan Meier estimate for allograft survival for DDRT at 90 years was 0.9%, in LDRT 3.6%. A total of 33 DDRT demonstrated physiologic function in excess of 90 years (median 92 years, maximum=97 years). 18 LDRT recipients demonstrate physiologic function in excess of 90 years (median 91 years, maximum=103.6 years). DDRT and LDRT allograft survival improved throughout the study period in similar fashion due to overall better graft function; however, DDRT demonstrates a greater improvement in survival. Multivariate analysis of each cohort identified the good donor and recipient factors as potential predictors of allograft longevity.
*Conclusions: Allograft longevity exceeding 100 physiologic years is possible. It represents a small but increasing minority of grafts in transplant recipients and more grafts will reach this mark with increasing follow-up time. The observation of extended longevity is higher among liver allograft recipients than renal allograft recipients. Increases in allograft longevity between DDRT and LDRT are similar over time but of greater magnitude in DDRT.
To cite this abstract in AMA style:Renz JF, Gruessner AC, Misawa RC, Masi A, Gruessner RW. The Centennial Allograft? Observation Of Greater Than 100-year Allograft Survival Is More Common Among Liver Allograft Recipients Than Renal Allograft Recipients. [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/the-centennial-allograft-observation-of-greater-than-100-year-allograft-survival-is-more-common-among-liver-allograft-recipients-than-renal-allograft-recipients/. Accessed June 29, 2022.
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