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Outcome of kidney transplantation from very senior donors in Switzerland - a national cohort study

Christian Kuhn, Brian M Lang, Sylvia Lörcher, Andrea Karolin, Isabelle Binet, Guido Beldi, Délaviz Golshayan, Karine Hadaya, Thomas F Mueller, Stefan Schaub, Franz Immer, Susanne Stampf, Michael Koller & Daniel Sidler

abstract Kidney transplantation from older and marginal donors is effective to confront organ shortage. However, limitations after transplantation of kidneys from very marginal kidney donors remain unclear. We compared patient and graft outcome, achieved allograft function and quality of life of renal transplantations from Very Senior Donors (VSD, defined as donors aged 70 years and older) with Senior Donors (SD, aged 60-70 years) and Regular Donors (RD, aged younger than 60 years) in Switzerland. We evaluated the outcome of 1554 adult recipients of deceased donor kidney transplantations from 05/2008 to 12/2019; median follow-up was 4.7 years. Failure-free survival (freedom from graft loss or death), glomerular filtration rate (eGFR), and quality of life at 12 months were analyzed for RD (reference group, n = 940), SD (n = 404), and VSD (n = 210). Failure-free survival decreased with increasing donor age, mainly attributable to premature graft loss. Still, overall 5-year failure-free survival reached 83.1%, 81.0%, and 64.0% in the RD, SD, and VSD subgroups, respectively. eGFR 12 months post-transplantation was significantly higher in RD compared with SD and VSD. The acceptance rate of donor candidates for kidney TPL was 78% for the entire cohort (87% for RD, 79% for SD, and 56% for VSD). Deceased donor kidney transplantation from donors aged 70 years or older is associated with an inferior, yet acceptable failure-free outcome, with sustained quality of life.
   
citation Kuhn C, Lang B M, Lörcher S, Karolin A, Binet I, Beldi G, Golshayan D, Hadaya K, Mueller T F, Schaub S, Immer F, Stampf S, Koller M, Sidler D. Outcome of kidney transplantation from very senior donors in Switzerland - a national cohort study. Transpl Int 2021; 34:689-699.
   
type journal paper/review (English)
date of publishing 05-03-2021
journal title Transpl Int (34/4)
ISSN electronic 1432-2277
pages 689-699
PubMed 33529392
DOI 10.1111/tri.13836