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- Title
Optimizing utilization of kidneys from deceased donors over 60 years: Five-year outcomes after implementation of a combined clinical and histological allocation algorithm.
- Authors
Sefora, Pierobon Elisa; Silvio, Sandrini; Nicola, De Fazio; Giuseppe, Rossini; Iris, Fontana; Luigino, Boschiero; Maria, Gropuzzo; Eliana, Gotti; Donato, Donati; Enrico, Minetti; Teresa, Gandolfo Maria; Anna, Brunello; Carmelo, Libetta; Antonio, Secchi; Stefano, Chiaramonte; Paolo, Rigotti
- Abstract
This 5 year observational multicentre study conducted in the Nord Italian Transplant programme area evaluated outcomes in patients receiving kidneys from donors over 60 years allocated according to a combined clinical and histological algorithm. Low-risk donors 60-69 years without risk factors were allocated to single kidney transplant (LR-SKT) based on clinical criteria. Biopsy was performed in donors over 70 years or 60-69 years with risk factors, allocated to Single (HR-SKT) or Dual kidney transplant (HR-DKT) according to the severity of histological damage. Forty HR-DKTs, 41 HR-SKTs and 234 LR-SKTs were evaluated. Baseline differences generally reflected stratification and allocation criteria. Patient and graft (death censored) survival were 90% and 92% for HR-DKT, 85% and 89% for HR-SKT, 88% and 87% for LR-SKT. The algorithm appeared user-friendly in daily practice and was safe and efficient, as demonstrated by satisfactory outcomes in all groups at 5 years. Clinical criteria performed well in low-risk donors. The excellent outcomes observed in DKTs call for fine-tuning of cut-off scores for allocation to DKT or SKT in high-risk patients.
- Publication
Transplant International, 2013, Vol 26, Issue 8, p833
- ISSN
0934-0874
- Publication type
Academic Journal
- DOI
10.1111/tri.12135