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Characterizing the risk of human leukocyte antigen-incompatible living donor kidney transplantation in older recipients.
Long, Jane J; Motter, Jennifer D; Jackson, Kyle R; Chen, Jennifer; Orandi, Babak J; Montgomery, Robert A; Stegall, Mark D; Jordan, Stanley C; Benedetti, Enrico; Dunn, Ty B; Ratner, Lloyd E; Kapur, Sandip; Pelletier, Ronald P; Roberts, John P; Melcher, Marc L; Singh, Pooja; Sudan, Debra L; Posner, Marc P; El-Amm, Jose M; Shapiro, Ron; Cooper, Matthew; Verbesey, Jennifer E; Lipkowitz, George S; Rees, Michael A; Marsh, Christopher L; Sankari, Bashir R; Gerber, David A; Wellen, Jason R; Bozorgzadeh, Adel; Gaber, A Osama; Heher, Eliot C; Weng, Francis L; Djamali, Arjang; Helderman, J Harold; Concepcion, Beatrice P; Brayman, Kenneth L; Oberholzer, Jose; Kozlowski, Tomasz; Covarrubias, Karina; Massie, Allan B; McAdams-DeMarco, Mara A; Segev, Dorry L; Garonzik-Wang, Jacqueline M.
Afiliação
  • Long JJ; Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Motter JD; Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
  • Jackson KR; Department of Surgery, Emory University, Atlanta, Georgia, USA.
  • Chen J; Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
  • Orandi BJ; Department of Surgery, University of Alabama, Birmingham, Alabama, USA.
  • Montgomery RA; Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
  • Stegall MD; Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
  • Jordan SC; Department of Medicine, Cedars-Sinai Comprehensive Transplant Center, Los Angeles, California, USA.
  • Benedetti E; Department of Surgery, University of Illinois-Chicago, Chicago, Illinois, USA.
  • Dunn TB; Department of Surgery, University of Pennsylvania, Philadelphia, Philadelphia, USA.
  • Ratner LE; Department of Surgery, Columbia University Medical Center, New York, New York, USA.
  • Kapur S; Department of Surgery, New York Presbyterian/Weill Cornell Medical Center, New York, New York, USA.
  • Pelletier RP; Department of Surgery, Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.
  • Roberts JP; Department of Surgery, University of California-San Francisco, San Francisco, California, USA.
  • Melcher ML; Department of Surgery, Stanford University, Palo Alto, California, USA.
  • Singh P; Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Philadelphia, USA.
  • Sudan DL; Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
  • Posner MP; Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA.
  • El-Amm JM; Integris Baptist Medical Center, Transplant Division, Oklahoma City, Oklahoma, USA.
  • Shapiro R; Recanati/Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA.
  • Cooper M; Medstar Georgetown Transplant Institute, Washington, District of Columbia, USA.
  • Verbesey JE; Medstar Georgetown Transplant Institute, Washington, District of Columbia, USA.
  • Lipkowitz GS; Department of Surgery, Baystate Medical Center Springfield, Massachusetts, Massachusetts, USA.
  • Rees MA; Department of Urology, University of Toledo Medical Center, Toledo, Ohio, USA.
  • Marsh CL; Department of Surgery, Scripps Clinic and Green Hospital, La Jolla, California, USA.
  • Sankari BR; Department of Urology, Cleveland Clinic, Cleveland, Ohio, USA.
  • Gerber DA; Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
  • Wellen JR; Department of Surgery, Barnes-Jewish Hospital, St. Louis, Missouri, USA.
  • Bozorgzadeh A; Department of Surgery, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts, USA.
  • Gaber AO; Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA.
  • Heher EC; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
  • Weng FL; Renal and Pancreas Transplant Division, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA.
  • Djamali A; Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA.
  • Helderman JH; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Concepcion BP; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Brayman KL; Department of Surgery, University of Virginia, Charlottesville, Virginia, USA.
  • Oberholzer J; Department of Surgery, University of Virginia, Charlottesville, Virginia, USA.
  • Kozlowski T; Department of Surgery, University of Florida, Gainesville, Florida, USA.
  • Covarrubias K; Department of Surgery, University of California San Diego, San Diego, California, USA.
  • Massie AB; Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA; Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.
  • McAdams-DeMarco MA; Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA; Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA.
  • Segev DL; Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA; Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA; Scientific Registry of Transplant Recipients, Minneapolis, Minnesota, USA.
  • Garonzik-Wang JM; Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA. Electronic address: garonzikwang@wisc.edu.
Am J Transplant ; 23(12): 1980-1989, 2023 Dec.
Article em En | MEDLINE | ID: mdl-37748554
ABSTRACT
Older compatible living donor kidney transplant (CLDKT) recipients have higher mortality and death-censored graft failure (DCGF) compared to younger recipients. These risks may be amplified in older incompatible living donor kidney transplant (ILDKT) recipients who undergo desensitization and intense immunosuppression. In a 25-center cohort of ILDKT recipients transplanted between September 24, 1997, and December 15, 2016, we compared mortality, DCGF, delayed graft function (DGF), acute rejection (AR), and length of stay (LOS) between 234 older (age ≥60 years) and 1172 younger (age 18-59 years) recipients. To investigate whether the impact of age was different for ILDKT recipients compared to 17 542 CLDKT recipients, we used an interaction term to determine whether the relationship between posttransplant outcomes and transplant type (ILDKT vs CLDKT) was modified by age. Overall, older recipients had higher mortality (hazard ratio 1.632.072.65, P < .001), lower DCGF (hazard ratio 0.360.530.77, P = .001), and AR (odds ratio 0.390.540.74, P < .001), and similar DGF (odds ratio 0.461.032.33, P = .9) and LOS (incidence rate ratio 0.880.981.10, P = 0.8) compared to younger recipients. The impact of age on mortality (interaction P = .052), DCGF (interaction P = .7), AR interaction P = .2), DGF (interaction P = .9), and LOS (interaction P = .5) were similar in ILDKT and CLDKT recipients. Age alone should not preclude eligibility for ILDKT.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transplante de Rim Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Humans / Middle aged Idioma: En Ano de publicação: 2023 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transplante de Rim Tipo de estudo: Etiology_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Humans / Middle aged Idioma: En Ano de publicação: 2023 Tipo de documento: Article