The "oldest and coldest" shipped living donor kidneys transplanted through kidney paired donation
The "oldest and coldest" shipped living donor kidneys transplanted through kidney paired donation
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DOI：
10.1111/ajt.15527
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发表时间：
2020-01-01
影响因子：
8.8
通讯作者：
Veale, Jeffrey L.
中科院分区：
文献类型：
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作者：
Nassiri, Nima;Kwan, Lorna;Veale, Jeffrey L.
迄今为止，已有数千个活体肾脏通过肾脏配对捐赠（KPD）运送。为了扩大活体供体移植这一不断增长的领域，我们使用2008年2月至2018年5月的国家肾脏登记数据库评估了高龄捐赠（“最老的肾脏”）和延长冷缺血时间（“最冷的肾脏”）对移植物功能和存活率的影响。供体按捐献时的年龄（≥ 65岁）分层，肾脏按冷缺血时间（≥ 16小时）分层。我们评估了移植后7年内移植肾功能延迟恢复和死亡删失移植肾衰竭（DCGF）。在2363例运送的活体供肾移植中，4.1%的供体年龄≥ 65岁，6.0%的移植肾冷缺血时间≥ 16小时。移植肾功能延迟和DCGF发生率分别为5.2%和4.7%。移植肾功能延迟恢复与供体年龄（P = 0.947）或冷缺血（P = 0.532）之间无显著相关性。供体年龄和冷缺血时间不能预测移植肾功能延迟恢复（OR = 0.86，1.20; P = .8，.6）或DCGF（HR = 1.38，0.35，P = .5，.1）。这些发现可能会缓解人们对老年供体或来自遥远移植中心的肾脏利用的担忧。
To date, thousands of living donor kidneys have been shipped through kidney paired donation (KPD). To expand on this growing segment of living donor transplantation, we evaluated the effect of advanced age donation ("oldest kidneys") and prolonged cold ischemia time ("coldest kidneys") on graft function and survival using the National Kidney Registry database from February 2008 to May 2018. Donors were stratified by age at time of donation (= 65 years) and kidneys were stratified by cold ischemia time (= 16 hours). We evaluated delayed graft function and death-censored graft failure (DCGF) for up to seven posttransplant years. Of the 2363 shipped living donor kidney transplants, 4.1% of donors were >= 65 years and 6.0% of transplanted kidneys had cold ischemia times >= 16 hours. Delayed graft function and DCGF occurred in 5.2% and 4.7% of cases. There were no significant associations between delayed graft function and donor age (P = .947) or cold ischemia (P = .532). Donor age and cold ischemia time were not predictive of delayed graft function (OR = 0.86,1.20; P = .8, .6) or DCGF (HR = 1.38,0.35, P = .5, .1). These findings may alleviate concerns surrounding the utilization of kidneys from older donors or those originating from distant transplant centers.