Early outcomes of kidney transplantation from elderly donors after circulatory death (GEODAS study)
Author
Pérez-Sáez, María José; Lafuente Covarrubias, Omar; Hernández, Domingo; Moreso, Francesc; Melilli, Edoardo; Juega, Javier; Sousa, Erika de; López-Sánchez, Paula; Rodríguez-Ferrero, María Luisa; Maruri-Kareaga, Naroa; Navarro, María Dolores; Valero, Rosalía; Mazuecos, María Auxiliadora; LLamas, Francisco; Martín-Moreno, Paloma; Fernández-García, Antón; Espí, Jordi; Jiménez, Carlos; Ramos, Ana; Gavela, Eva; Portolés Pérez, José María; Behalf of the GEODAS GroupEntity
UAM. Departamento de MedicinaPublisher
BMC part of Springer NatureDate
2019-06-26Citation
10.1186/s12882-019-1412-0
BMC Nephrology 20 (2019): 233
ISSN
1471-2369DOI
10.1186/s12882-019-1412-0Funded by
This project was co-founded by Public Research Net REDINREN ISCIII 16/009/ 009, Renal Foundation FRIAT & Research Institute Segovia Arana-HU Puerta de Hierro. OLC, PLS and JMP belong to the latter institution (HU Puerta de Hierro). Funding was used for human resources: data manager and statistician supportProject
Gobierno de España. ISCIII 16/009/009Editor's Version
https://doi.org/10.1186/s12882-019-1412-0Subjects
Kidney transplantation; Elderly donors; Donors after circulatory death; Clinical outcomes; Delayed graft function; MedicinaRights
© 2019 The AuthorsAbstract
Background: Spain has dramatically increased the number of controlled circulatory death donors (cDCD). The
initial selection criteria for considering cDCD for kidney transplantation (KT) have been expanded progressively, with
practically no limits in donor age during the last years. We aimed to analyze the early clinical outcomes using
expanded (> 65 years) cDCD in comparison with standard ones.
Methods: Observational multicenter study including 19 transplant centers in Spain. We performed a systematic
inclusion in a central database of every KT from expanded cDCD at each participant unit from January-2012 to
January-2017. Surgical procedures and immunosuppressive protocols were based on local practices. Data was
analyzed in the central office using logistic and Cox regression or competitive-risk models for multivariate analysis.
Median time of follow-up was 18.1 months.
Results: 561 KT were performed with kidneys from cDCD, 135 from donors older than 65 years. As expected,
recipients from older cDCD were also older (65.8 (SD 8.8) vs 53.7 (SD 11.4) years; p < 0.001) and with higher
comorbidity. At 1 year, no differences were found amongst older and younger cDCD KT recipients in terms of
serum creatinine (1.6 (SD 0.7) vs 1.5 (SD 0.8) mg/dl; p = 0.29). Non-death censored graft survival was inferior, but
death-censored graft survival was not different (95.5 vs 98.2% respectively; p = 0.481). They also presented a trend
towards higher delayed graft function (55.4 vs 46.7%; p = 0.09) but a similar rate of primary non-function (3.7 vs
3.1%; p = 0.71), and acute rejection (3.0 vs 6.3%; p = 0.135). In the multivariate analysis, in short follow-up, donor age
was not related with worse survival or poor kidney function (eGFR < 30 ml/min).
Conclusions: The use of kidneys from expanded cDCD is increasing for older and comorbid patients. Short-term
graft outcomes are similar for expanded and standard cDCD, so they constitute a good-enough source of kidneys to improve the options of KT wait-listed patients
Files in this item
Google Scholar:Pérez-Sáez, María José
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Lafuente Covarrubias, Omar
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Hernández, Domingo
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Moreso, Francesc
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Melilli, Edoardo
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Juega, Javier
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Sousa, Erika de
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López-Sánchez, Paula
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Rodríguez-Ferrero, María Luisa
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Maruri-Kareaga, Naroa
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Navarro, María Dolores
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Valero, Rosalía
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Mazuecos, María Auxiliadora
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LLamas, Francisco
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Martín-Moreno, Paloma
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Fernández-García, Antón
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Espí, Jordi
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Jiménez, Carlos
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Ramos, Ana
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Gavela, Eva
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Portolés Pérez, José María
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Behalf of the GEODAS Group
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