Early outcomes of kidney transplantation from elderly donors after circulatory death (GEODAS study)
Pérez-Sáez, María José (Parc de Salut MAR de Barcelona)
Lafuente Covarrubias, Omar (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Moreso, Francesc. (Hospital Universitari Vall d'Hebron)
Melilli, Edoardo (Hospital Universitari de Bellvitge)
Juega-Mariño, Javier (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
De Souza, Erika (Hospital Universitario Clínic de Barcelona (Barcelona))
López-Sánchez, Paula (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Rodríguez-Ferrero, María Luisa (Hospital General Universitario Gregorio Marañón)
Maruri-Kareaga, Naroa (Hospital Universitario de Cruces (Barakaldo, País Basc))
Navarro, María Dolores (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Valero, Rosalía (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Mazuecos, María Auxiliadora (Hospital Universitario Puerta del Mar (Cadis, Andalusia))
Llamas, Francisco (Complejo Hospitalario Universitario de Albacete)
Martín-Moreno, Paloma (Clínica Universidad de Navarra)
Fernández-García, Antón (Complejo Hospitalario Universitario de A Coruña)
Espí, Jordi (Hospital Universitari i Politècnic La Fe (València))
Jiménez Martín, Carlos (Hospital Universitario La Paz (Madrid))
Ramos, Ana (Hospital Universitario Fundación Jiménez Díaz)
Gavela, Eva (Hospital Universitario Doctor Peset (Valencia))
Pascual, Julio (Parc de Salut MAR de Barcelona)
Portolés, Jose M. (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Lafuente Covarrubias, Omar (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Sánchez-Sobrino, Beatriz (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Zapatero Ferrándiz, Ana (Hospital del Mar (Barcelona, Catalunya))
Hernández Marrero, Domingo (Hospital Regional Universitario de Málaga)
Manonelles, Anna (Hospital Universitari de Bellvitge)
Lauzurica, Ricardo (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
De Souza, Erika (Hospital Clínic i Provincial de Barcelona)
Diekmann, Fritz (Hospital Clínic i Provincial de Barcelona)
Zárraga, Sofía (Hospital Universitario de Cruces (Barakaldo, País Basc))
Rodríguez-Benot, Alberto (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Ruiz, Juan Carlos (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Alonso Hernández, Ángel (Complejo Hospitalario Universitario de A Coruña)
Beneyto, Isabel (Hospital Universitari i Politècnic La Fe (València))
López-Oliva, María (Hospital Universitario La Paz (Madrid))
Sancho Calabuig, Asunción (Hospital Universitario Doctor Peset (Valencia))

Date:	2019
Abstract:	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.
Grants:	Instituto de Salud Carlos III REDINREN/16-009-009
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	BMC Nephrology, Vol. 20 Núm. 1 (26 2019) , p. 233, ISSN 1471-2369

DOI: 10.1186/s12882-019-1412-0
PMID: 31242927

8 p, 619.2 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles