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.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.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.doi http://dx.doi.org/10.1093/ckj/sfaa114
  • dc.identifier.issn 2048-8505
  • dc.identifier.uri http://hdl.handle.net/10230/48411
  • 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.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
  • 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.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.type.version info:eu-repo/semantics/publishedVersion

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