Benefits of Living Over Deceased Donor Kidney Transplantation in Elderly Recipients. A Propensity Score Matched Analysis of a Large European Registry Cohort
Year: 2024
Type: article
Study design: Observational Study
Abstract: Although kidney transplantation from living donors (LD) offers better long-term results than from deceased donors (DD), elderly recipients are less likely to receive LD transplants than younger ones. We analyzed renal transplant outcomes from LD versus DD in elderly recipients with a propensity-matched score. This retrospective, observational study included the first single kidney transplants in recipients aged ≥65 years from two European registry cohorts (2013–2020, n = 4,257). Recipients of LD (n = 408), brain death donors (BDD, n = 3,072), and controlled cardiocirculatory death donors (cDCD, n = 777) were matched for donor and recipient age, sex, dialysis time and recipient diabetes. Major graft and patient outcomes were investigated. Unmatched analyses showed that LD recipients were more likely to be transplanted preemptively and had shorter dialysis times than any DD type. The propensity score matched Cox’s regression analysis between LD and BDD (387-pairs) and LD and cDCD (259-pairs) revealing a higher hazard ratio for graft failure with BDD (2.19 [95% CI: 1.16–4.15], p = 0.016) and cDCD (3.38 [95% CI: 1.79–6.39], p < 0.001). One-year eGFR was higher in LD transplants than in BDD and cDCD recipients. In elderly recipients, LD transplantation offers superior graft survival and renal function compared to BDD or cDCD. This strategy should be further promoted to improve transplant outcomes.
Source: Transplant International
Authors: Néstor Toapanta, Jordi Comas, Ignacio Revuelta, Anna Manonelles, Carme Facundo, María José Pérez-Saez, Anna Vila, Emma Arcos, Jaume Tort, Magali Giral, Maarten Naesens, Dirk Kuypers, Anders Asberg, Francesc Moreso, Oriol Bestard
Institutions: Universitat Autònoma de Barcelona, Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Bellvitge University Hospital, Institut d'Investigació Biomédica de Bellvitge, Universitat de Barcelona, Puigvert Foundation, Hospital Del Mar, Hospital Universitari Germans Trias i Pujol, Inserm, Centre Hospitalier Universitaire de Nantes, Institut de Transplantation Urologie en Nephrologie, Fondation Centaure, Center for Research in Transplantation and Translational Immunology, Université de Nantes, Nantes Université, KU Leuven, Hôpital Necker-Enfants Malades, Universitair Ziekenhuis Leuven, Oslo University Hospital, University of Oslo
Language: English
Subfield: Transplantation
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,922
Awards: Algoritmo de evolución del injerto en trasplante renal, G3114265307, Contribución de la aloreactividad y autoreactividad en el microambiente inflamatorio local en el rechazo mediado por anticuerpos en trasplante renal, Hacia un manejo clínico personalizado de pacientes oncológicos con fracaso renal agudo asociado a los immune-checkpoint inhibitors (ICIs), Mecanismos y dianas terapéuticas de la respuesta Inmunológica Humoral de Memoria facilitando el rechazo del injerto en el trasplante renal
OpenAlex ID: W4401960337