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Observational Study
. 2021 Dec;34(12):2746-2754.
doi: 10.1111/tri.14130. Epub 2021 Oct 28.

Comparative survival of elderly renal transplant recipients with a living donor versus a deceased donor: A retrospective single center observational study

Erzsi Tegzess  1 , Antonio W Gomes Neto  1 , Robert A Pol  2 , Silke E de Boer  1 , Hessel Peters-Sengers  3 , Jan-Stephan F Sanders  1 , Stefan P Berger  1
Affiliations
Observational Study

Comparative survival of elderly renal transplant recipients with a living donor versus a deceased donor: A retrospective single center observational study

Erzsi Tegzess et al. Transpl Int. 2021 Dec.

Abstract

Increasing numbers of elderly (≥65 years) patients are listed for kidney transplantation. This study compares the survival outcome between living (LDK), regularly allocated (ETKAS), and Eurotransplant Senior Program (ESP) donor kidneys in elderly recipients. This is a single-center retrospective cohort study of elderly kidney transplant recipients transplanted between 2005 and 2017. Primary outcome measures were nondeath-censored graft, death-censored graft, and patient survival. In total, 348 patients were transplanted, 109 recipients (31.3%) received an LDK, 100 (28.7%) an ETKAS, and 139 (40%) an ESP kidney. 62.5% were male, and median age was 68 years. LDK recipients had significantly better 5-year nondeath-censored graft survival compared with ETKAS and ESP (resp. 71.0% vs. 66.1% vs. 55.6%, P = 0.047). Death-censored graft survival after 1 year was significantly better in LDK recipients (99.1%) (ETKAS 90.8%; ESP 87.7%, P < 0.001). After 5 years, the difference remained significant (P < 0.001) with little additional graft loss (97.7% vs. 88.1% vs. 85.6). There was no significant difference in patient survival after 5 years (71.7% vs. 67.4% vs 61.9%, P = 0.480). In elderly recipients, the patient survival benefits of an LDK are limited, but there is decreased death-censored graft loss for LDK recipients. Nevertheless, graft survival in ETKAS and ESP remains satisfactory.

Keywords: deceased donor; elderly patients; graft survival; kidney transplantation; living donor; patient survival.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study inclusion flow chart. LDK: Living donor kidney; ETKAS: Deceased donor allocated within Eurotransplant kidney allocation system; ESP: Deceased donor allocated within the Eurotransplant Senior Program.
Figure 2
Figure 2
Survival curves with patients at risk. (a) Graft survival (P = 0.047); (b) Death‐censored graft survival (P = 0.005); (c) Patient survival (P = 0.480).
Figure 3
Figure 3
eGFR per group. LDK: Living donor kidney; ETKAS: Deceased donor allocated within Eurotransplant kidney allocation system; and ESP: Deceased donor allocated within the Eurotransplant Senior Program.
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References

    1. van Leiden HA, Heemskerk MBA, de Buijzer E, Smand CE, Busato CMJ, Haase‐Kromwijk BJJM. Nederlandse Transplantatie Stichting Jaarverslag 2005.
    1. de Groot S, Haase‐Kromwijk B, Heemskerk M, et al. Nederlandse Transplantatie Stichting Jaarverslag 2017.
    1. Terasaki PI, Cecka JM, Gjertson DW, Takemoto S. High survival rates of kidney transplants from spousal and living unrelated donors. N Engl J Med 1995; 333: 333. - PubMed
    1. Roodnat JI, van Riemsdijk IC, Mulder PGH, et al. The superior results of living‐donor renal transplantation are not completely caused by selection or short cold ischemia time: a single‐center, multivariate analysis. Transplantation 2003; 75: 2014. - PubMed
    1. Frei U, Noeldeke J, Machold‐Fabrizii V, et al. Prospective age‐matching in elderly kidney transplant recipients–a 5‐year analysis of the Eurotransplant Senior Program. Am J Transplant 2008; 8: 50. - PubMed

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