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Long-Term Results of Kidney Transplantation in the Elderly: Comparison between Different Donor Settings.
Yemini, Renana; Rahamimov, Ruth; Ghinea, Ronen; Mor, Eytan.
Afiliação
  • Yemini R; Department of Surgery, Samson Assuta Ashdod University Hospital, Ashdod 7747629, Israel.
  • Rahamimov R; Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva 8410501, Israel.
  • Ghinea R; Institute of Nephrology, Beilinson Medical Center, Petach-Tikva 49100, Israel.
  • Mor E; Sackler Medical School, Tel-Aviv University, Tel-Aviv 6997801, Israel.
J Clin Med ; 10(22)2021 Nov 15.
Article em En | MEDLINE | ID: mdl-34830587
With scarce organ supply, a selection of suitable elderly candidates for transplant is needed, as well as auditing the long-term outcomes after transplant. We conducted an observational cohort study among our patient cohort >60 years old with a long follow up. (1). PATIENTS AND METHODS: We used our database to study the results after transplant for 593 patients >60 years old who underwent a transplant between 2000-2017. The outcome was compared between live donor (LD; n = 257) recipients, an old-to-old (OTO, n = 215) group using an extended criteria donor (ECD) kidney, and a young-to-old (YTO, n = 123) group using a standard-criteria donor. The Kaplan-Meir method was used to calculate the patient and graft survival and Cox regression analysis in order to find risk factors associated with death. (2). RESULTS: The 5- and 10-year patient survival was significantly better in the LD group (92.7% and 66.9%) compared with the OTO group (73.3% and 42.8%) and YTO group (70.9% and 40.6%) (p < 0.0001). The 5- and 10-year graft survival rates were 90.3% and 68.5% (LD), 61.7% and 30.9% (OTO), and 64.1% and 39.9%, respectively (YTO group; p < 0.0001 between the LD and the two DD groups). There was no difference in outcome between patients in their 60's and their 70's. Factors associated with mortality included: age (HR-1.060), DM (HR-1.773), IHD (HR-1.510), and LD/DD (HR-2.865). (3). CONCLUSIONS: Our 17-years of experience seems to justify the rational of an old-to-old allocation policy in the elderly population. Live-donor transplant should be encouraged whenever possible. Each individual decision of elderly candidates for transplant should be based on the patient's comorbidity and predicted life expectancy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: J Clin Med Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Israel País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: J Clin Med Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Israel País de publicação: Suíça