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11 February 2016 : Original article  

Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program (ESP): A Single-Center Experience from 2008 to 2013

Johannes JacobiABCDEFG, Sophie BeckmannBCF, Katharina HellerDF, Karl F. HilgersCDE, Hendrik ApelD, Bernd SpriewaldBD, Kai-Uwe EckardtDE, Kerstin U. AmannBCDE

DOI: 10.12659/AOT.895731

Ann Transplant 2016; 21:94-104

Abstract

BACKGROUND: The aim of this study was to evaluate the outcome after transplantation of deceased allografts in donor/recipient pairs aged ≥65 years enrolled in the Eurotransplant Senior Program (ESP).

MATERIAL AND METHODS: In this retrospective cohort study we evaluated data from 89 patients transplanted under the ESP protocol from 2008 to 2013. Outcome parameters included graft and patient survival, rate of biopsy-proven acute rejections (BPAR), peri- and post-operative complications, tumor development, development of donor-specific antibodies (DSA), and the prognostic role of preimplantation biopsies.

RESULTS: One-year patient and allograft survival rates were 92.1% and 84.3%, respectively. During follow-up, 23 (26%) patients died; the major cause of death was sepsis, followed by cardiovascular events and malignancies. BPAR episodes were frequent within the first year (~33%) and overall were less common in patients treated with tacrolimus. Post-transplant malignancies were seen in 15 (17%) patients. During follow-up, 16 (18%) patients developed DSA; patients with delayed graft function (DGF) were more likely to develop DSA (p=0.029). A higher preimplantation biopsy score was associated with DGF but did not predict later graft outcome.

CONCLUSIONS: The results highlight increased risks in ESP transplant candidates and the importance of careful surveillance of this patient group.

Keywords: Graft Rejection, Kidney Transplantation, Survival Rate

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358