Results of Transplantation of Kidneys Procured From Donors After Brain Death Aged 60 Years and Older |
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Authors: | S. Franczyk D. Skrabaka E. Jędrusik J. Ziaja A. Kolonko R. Świder S. Sekta J. Czerwiński A.J. Owczarek M. Durlik A. Więcek L. Cierpka R. Król |
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Affiliation: | 1. Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Poland;2. Department of Statistics, Department of Instrumental Analysis, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Sosnowiec, Poland;3. Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland;4. Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Warsaw, Poland;5. Polish Transplant Coordinating Center (Poltransplant), Warsaw, Poland;6. Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland |
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Abstract: | ObjectiveTo analyze results of transplantation of kidneys procured from donors after brain death aged 60 years and older (hereafter denoted by “≥60”) compared to kidneys procured from donors after brain death aged 40–59 years (hereafter denoted by “40–59”) in medium-term follow-up period, and to assess factors that affect recipient and kidney graft survival.Material and methods92 transplant recipients of kidneys procured from donors after brain death ≥60 were enrolled into the study. The control group were 363 recipients of kidneys procured from donors after brain death 40–59.ResultsMean values of serum creatinine were higher in recipients of kidneys procured from donors after brain death ≥60 compared to control after 3 years: 168.2 ± 57.5 (n = 59) vs 147.9 ± 65.7 (n = 294), P < .05; and after 5 years: 196.2 ± 95.3 (n = 38) vs 157.3 ± 80.0 μmol/L (n = 211), P < .01. Restricted mean recipient survival time was 56.4 (95% confidence interval: 55.0–57.8) and 52.0 (48.0–56.1) months, P < .05; and kidney graft survival time was 51.6 (49.6–53.5) and 43.9 (39.0–48.9) months, P < .01 in recipients who received kidneys from donors after brain death 40–59 and from donors after brain death ≥60 respectively. In Cox regression, donor death due to cardiovascular disease proved to be the factor increasing risk of kidney graft loss (hazard ratio 1.553, P < .001).ConclusionsThe survival and function of kidneys procured from donors after brain death ≥60 at medium-term follow-up remain worse compared to kidneys procured from donors after brain death 40–59, and the donor dependent risk factor of kidney graft loss is cardiovascular disease, which caused donor death. |
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Keywords: | Address correspondence to Jacek Ziaja, Department of General, Vascular, and Transplant Surgery, Medical University of Silesia, ul. Francuska 20, 40-027 Katowice, Poland. Phone: +48 603 680 860 Fax: +48 32 255 50 52. |
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