Should kidney allografts from old donors be allocated only to old recipients?

被引:14
|
作者
Suesal, Caner [1 ]
Kumru, Gizem [1 ]
Doehler, Bernd [1 ]
Morath, Christian [2 ]
Baas, Marije [3 ]
Lutz, Jens [4 ]
Unterrainer, Christian [1 ]
Arns, Wolfgang [5 ]
Aubert, Olivier [6 ,7 ]
Bara, Christoph [8 ]
Beiras-Fernandez, Andres [9 ]
Boehmig, Georg A. [10 ]
Boesmueller, Claudia [11 ]
Diekmann, Fritz [12 ]
Dutkowski, Philipp [13 ]
Hauser, Ingeborg [14 ]
Legendre, Christophe [6 ,7 ]
Lozanovski, Vladimir J. [15 ]
Melk, Anette [16 ]
Minor, Thomas [17 ]
Mueller, Thomas F. [18 ]
Pisarski, Przemyslaw [19 ]
Rostaing, Lionel [20 ]
Schemmer, Peter [21 ]
Schneeberger, Stefan [10 ]
Schwenger, Vedat [22 ]
Sommerer, Claudia [2 ]
Toenshoff, Burkhard [23 ]
Viebahn, Richard [24 ]
Viklicky, Ondrej [25 ]
Weimer, Rolf [26 ]
Weiss, Karl-Heinz [27 ]
Zeier, Martin [2 ]
Zivcic-Cosic, Stela [28 ]
Heemann, Uwe [29 ]
机构
[1] Heidelberg Univ Hosp, Inst Immunol, Heidelberg, Germany
[2] Heidelberg Univ Hosp, Div Nephrol, Heidelberg, Germany
[3] Radboud Univ Nijmegen, Radboud Inst Hlth Sci, Dept Nephrol, Med Ctr, Nijmegen, Netherlands
[4] Gemeinschaftsklinikum Mittelrhein, Div Nephrol & Infect Dis, Med Clin, Koblenz, Germany
[5] Cologne Merheim Med Ctr, Dept Nephrol & Transplantat, Cologne, Germany
[6] Paris Descartes Univ, Hop Necker Enfants Malad, AP HP, Serv Transplantat Renale, Paris, France
[7] Paris Descartes Univ, Hop Necker Enfants Malad, AP HP, Unite Soins Intensifs, Paris, France
[8] Hannover Med Sch, Div Thorac Transplantat & Cardiovasc Surg, Hannover, Germany
[9] Univ Hosp, Dept Cardiothorac & Vasc Surg, Johannes Gutenberg Univ, Mainz, Germany
[10] Med Univ Vienna, Dept Med 3, Div Nephrol & Dialysis, Vienna, Austria
[11] Med Univ Innsbruck, Dept Visceral Transplant & Thorac Surg, Innsbruck, Austria
[12] Hosp Clin Barcelona, Dept Nephrol & Renal Transplantat, ICNU, Barcelona, Spain
[13] Univ Hosp Zurich, Swiss HPB & Transplantat Ctr, Dept Surg & Transplantat, Zurich, Switzerland
[14] Goethe Univ, Dept Nephrol, UKF, Med Klin 3, Frankfurt, Germany
[15] Univ Hosp Heidelberg, Dept Gen & Transplant Surg, Heidelberg, Germany
[16] Hannover Med Sch, Dept Pediat Kidney Liver & Metab Dis, Hannover, Germany
[17] Univ Duisburg Essen, Univ Hosp Essen, Clin Gen Visceral & Transplantat Surg, Dept Surg Res, Duisburg, Germany
[18] Univ Hosp Zurich, Div Nephrol, Zurich, Switzerland
[19] Univ Freiburg, Fac Med, Dept Gen & Visceral Surg, Med Ctr, Freiburg, Germany
[20] CHU Grenoble Alpes, Serv Nephrol Dialyse Aphereses & Transplantat, Grenoble, France
[21] Med Univ Graz, Dept Surg Gen Visceral & Transplant Surg, Graz, Austria
[22] Klinikum Stuttgart, Dept Nephrol & Autoimmune Dis, Transplantat Ctr, Stuttgart, Germany
[23] Univ Childrens Hosp Heidelberg, Dept Pediat 1, Heidelberg, Germany
[24] Ruhr Univ Bochum, Univ Hosp Knappschaftskrankenhaus Bochum, Dept Surg, Bochum, Germany
[25] Inst Clin & Expt Med, Dept Nephrol, Prague, Czech Republic
[26] Univ Giessen, Dept Internal Med, Giessen, Germany
[27] Univ Hosp Heidelberg, Dept Internal Med Gastroenterol & Hepatol 4, Heidelberg, Germany
[28] Univ Rijeka, Clin Hosp Ctr Rijeka, Fac Med, Dept Nephrol Dialysis & Kidney Transplantat, Rijeka, Croatia
[29] Tech Univ Munich, Dept Nephrol, Klinikum Rechts Isar, Munich, Germany
关键词
kidney clinical; expanded donor pool; donation; outcome; EXPANDED CRITERIA DONORS; EARLY IMMUNE-RESPONSE; QUALITY-OF-LIFE; RENAL-TRANSPLANTATION; COLD-STORAGE; MACHINE PERFUSION; SURVIVAL BENEFIT; ELDERLY DONORS; AGE; COMPLICATIONS;
D O I
10.1111/tri.13628
中图分类号
R61 [外科手术学];
学科分类号
摘要
In several deceased donor kidney allocation systems, organs from elderly donors are allocated primarily to elderly recipients. The Eurotransplant Senior Program (ESP) was implemented in 1999, and since then, especially in Europe, the use of organs from elderly donors has steadily increased. The proportion of >= 60-year-old donors reported to the Collaborative Transplant Study (CTS) by European centers has doubled, from 21% in 2000-2001 to 42% in 2016-2017. Therefore, in the era of organ shortage it is a matter of debate whether kidney organs from elderly donors should only be allocated to elderly recipients or whether <65-year-old recipients can also benefit from these generally as "marginal" categorized organs. To discuss this issue, a European Consensus Meeting was organized by the CTS on April 12, 2018, in Heidelberg, in which 36 experts participated. Based on available evidence, it was unanimously concluded that kidney organs from 65- to 74-year-old donors can also be allocated to 55- to 64-year-old recipients, especially if these organs are from donors with no history of hypertension, no increased creatinine, no cerebrovascular death, and no other reasons for defining a marginal donor, such as diabetes or cancer.
引用
收藏
页码:849 / 857
页数:9
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