Abstract | BACKGROUND: The results of the transplantation of marginal donor kidneys remain controversial. This study aimed to investigate the impact of donor risk factors as predictors of kidney-graft outcome. METHODS: Allograft failure risk factors were studied in 7,209 cadaveric kidney-transplant recipients reporting to the Etablissement français des Greffes (EfG) from 1996 to 2000, of which 544 (7.6%) were from donors aged over 60. Both univariate and multivariate analysis were used to assess the effect of donor risk factors and were stratified according to recipient age. RESULTS: Overall graft survival was 91.1% (95% confidence interval [CI] 90.5-91.8) at 1 year, 88.6% (95% CI 87.8-89.4) at 2 years, and 85.6% (95% CI 84.6-86.6) at 3 years posttransplant. Univariate analysis of risk factors showed a significant reduction of graft survival in recipients transplanted with kidneys coming from donors older than 60 years, donors with a history of hypertension, a cerebrovascular cause of death, and a preharvesting serum creatinine greater than 150 micromol/L. Multivariate analysis revealed significantly higher failure rate associated with cerebrovascular cause of death (RR=1.2, P=0.02), history of hypertension (RR=1.2, P=0.04), and elevated serum creatinine (RR=1.3, P=0.03), whereas donor age greater than 60 years was not found as an independent risk factor. CONCLUSIONS: Our results suggest that cerebrovascular cause of death, history of hypertension, and elevated creatinine are significant independent donor risk factors for graft survival, whereas donor age is a statistically significant, but dependent, risk factor. This result is important for the design of allocation and transplantation strategies for kidneys procured in elderly donors.
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Authors | Fabienne Pessione, Sophie Cohen, Dominique Durand, Maryvonne Hourmant, Michèle Kessler, Christophe Legendre, Georges Mourad, Christian Noël, Marie-Noëlle Peraldi, Claire Pouteil-Noble, Philippe Tuppin, Christian Hiesse |
Journal | Transplantation
(Transplantation)
Vol. 75
Issue 3
Pg. 361-7
(Feb 15 2003)
ISSN: 0041-1337 [Print] United States |
PMID | 12589160
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Adult
- Age Distribution
- Cerebrovascular Disorders
(mortality)
- Female
- Graft Survival
- Humans
- Hypertension
(mortality)
- Kidney Transplantation
(mortality)
- Male
- Middle Aged
- Multivariate Analysis
- Proportional Hazards Models
- Retrospective Studies
- Risk Factors
- Survival Analysis
- Tissue Donors
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