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Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors

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dc.contributor.author Buxeda, Anna
dc.contributor.author Velis, Gonzalo
dc.contributor.author Arias Cabrales, Carlos Enrique
dc.contributor.author Zapatero, Ana
dc.contributor.author Burballa Tàrrega, Carla, 1988-
dc.contributor.author Redondo Pachón, María Dolores
dc.contributor.author Mir, Marisa
dc.contributor.author Crespo Barrio, Marta
dc.contributor.author Pascual Santos, Julio
dc.contributor.author Pérez-Sáez, María José
dc.date.accessioned 2021-09-08T06:21:18Z
dc.date.available 2021-09-08T06:21:18Z
dc.date.issued 2020
dc.identifier.citation Buxeda A, Velis G, Arias-Cabrales C, Zapatero A, Burballa C, Redondo-Pachón D, Mir M, Crespo M, Pascual J, Pérez-Sáez MJ. Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors. Clin Kidney J. 2020;14(4):1181-9. DOI: 10.1093/ckj/sfaa114
dc.identifier.issn 2048-8505
dc.identifier.uri http://hdl.handle.net/10230/48411
dc.description.abstract Background: The use of kidneys from elderly controlled donation after circulatory death (cDCD) donors has increased significantly in recent years. Concerns about outcomes achieved with these elderly cDCD kidneys have arisen. We aimed to compare outcomes from elderly cDCD kidney transplant recipients (KTrs) and elderly donation after brain death donors (DBDs) in KTrs. Methods: We conducted a single-centre retrospective study including 87 cDCD-KTrs (46 from donors ≥65 years of age and 41 from <65 years) and 126 DBD-KTrs from donors ≥65 years of age from 2013 through 2017). Young cDCD-KTrs were used as controls. The median follow-up was 27.1 months for all cDCD-KTrs and 29.7 months for DBD-KTrs ≥65 years of age. Results: Donors >65 years of age represented more than half of our global cDCD cohort (52.9%). KTs from elderly cDCDs had similar rates of delayed graft function, primary non-function and vascular complications compared with young cDCD-KTrs and elderly DBD-KTrs. Short and medium-term graft survival from elderly cDCD kidneys are excellent and are comparable to those from young cDCD and elderly DBD kidneys (90% young cDCD versus 88% elderly cDCD versus 80% elderly DBD at 36 months, P = 0.962 and 0.180, respectively). Although recipients from cDCDs ≥65 years of age showed lower 3-year patient survival (78% versus 87% in elderly DBD-KTrs; P = 0.01), recipient age was the only determinant of patient survival [hazard ratio 1.10 (95% confidence interval 1.02-1.17); P < 0.01], without any influence of donor characteristics. Conclusions: The use of kidneys from elderly cDCDs is increasing in Spain. Short- and medium-term graft outcomes are similar when comparing kidneys from elderly cDCDs and DBDs. Recipient age is the only determinant of patient survival. Additional studies are needed to assess long-term outcomes.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartof Clin Kidney J. 2020;14(4):1181-9
dc.rights © The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
dc.title Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1093/ckj/sfaa114
dc.subject.keyword Brain death donors
dc.subject.keyword Clinical outcomes
dc.subject.keyword Donors after circulatory death
dc.subject.keyword Elderly donors
dc.subject.keyword Kidney transplantation
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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