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Impact of Combinations of Donor and Recipient Ages and Other Factors on Kidney Graft Outcomes.
Gerbase-DeLima, Maria; de Marco, Renato; Monteiro, Franscisco; Tedesco-Silva, Hélio; Medina-Pestana, José O; Mine, Karina L.
Afiliação
  • Gerbase-DeLima M; Instituto de Imunogenética, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil.
  • de Marco R; Instituto de Imunogenética, Associação Fundo de Incentivo à Pesquisa, São Paulo, Brazil.
  • Monteiro F; Secretaria do Estado da Saúde, São Paulo, Brazil.
  • Tedesco-Silva H; Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.
  • Medina-Pestana JO; Hospital do Rim, Fundação Oswaldo Ramos, São Paulo, Brazil.
  • Mine KL; Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Front Immunol ; 11: 954, 2020.
Article em En | MEDLINE | ID: mdl-32528472
As the availability of kidneys for transplantation continues to be outpaced by its growing demand, there has been an increasing utilization of older deceased donors in the last decades. Considering that definition of factors that influence deceased donor kidney transplant outcomes is important for allocation policies, as well as for individualization of post-transplant care, the purpose of this study was determine the risks for death censored graft survival and for patient survival conferred by older age of the donor in the context of the age of the recipient and of risk factors for graft and/or patient survival. The investigation was conducted in a single-center cohort of 5,359 consecutive first kidney transplants with adult deceased donors performed on non-prioritized adult recipients from January 1, 2002, to December 31, 2017. Death censored graft survival and patient survival were lower in older donors, whereas graft survival was higher and patient survival was lower in old recipients. The analyses of combinations of donor and recipient ages showed that death censored graft survival was lower in younger recipients in transplants from 18 to 59-year old donors, with standard or extended criteria, but no difference in graft survival was observed between younger and older recipients when the donor was ≥ 60-year old. Patient survival was higher in younger recipients in transplants with younger or older donors. Two to six HLA-A,B,DR mismatches, when compared to 0-1 MM, conferred risk for death-censored graft survival only in transplants from younger donors to younger recipients. Pre-transplant diabetes conferred risk for patient survival only in 50-59-year old recipients, irrespectively, of the age of the donor. Time on dialysis ≥ 10 years was a risk factor for patient survival in transplants with all donor-recipient age combinations, except in recipients with ≥ 60 years that received a kidney from an 18-49-year old donor. In conclusion, the results obtained in this study underline the importance of analyzing the impact of the age of the donor taking into consideration different scenarios.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doadores de Tecidos / Transplante de Rim / Seleção do Doador / Transplantados / Sobrevivência de Enxerto Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Front Immunol Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doadores de Tecidos / Transplante de Rim / Seleção do Doador / Transplantados / Sobrevivência de Enxerto Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Front Immunol Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça