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Erschienen in: European Surgery 5/2020

24.04.2020 | original article

Impact of the elderly donor on an abdominal organ transplantation program

verfasst von: MD, PhD María Ángeles Ballesteros, MD, PhD Borja Suberviola, MD Lara Belmar Vega, MD Roberto Fernández-Santiago, MD Sandra Campos Fernández, MD, PhD Juan Carlos Ruiz San Millán, MD, PhD Eduardo Miñambres

Erschienen in: European Surgery | Ausgabe 5/2020

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Summary

Background

Older donors have become widespread in recent years. Given that they have comorbidities, the treatment of theses donors is crucial. Our aim was to analyze the influence of the elderly donor (≥65 years) on the subsequent evolution of liver and kidney recipients.

Methods

Retrospective study including all liver and kidney transplants performed at the Marqués de Valdecilla University Hospital with grafts generated from local donors in brain death. Period: 2014–2017. Two groups were considered, depending on the age of the donor (≥ or <65 years).

Results

There were 37 older donors (from 100 donors in brain death). Fourteen liver transplants were performed with old grafts that were characterized by a lower Model for End-stage Liver Disease (MELD) score (13.5 [interquartile range (IQR): 10–14] vs. 19 [IQR: 16–22], p: 0.004). The values of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were higher over time in the older graft recipients. 18 renal transplants were performed with grafts from older donors. This group were older (62 vs. 57, p: 0.001) and had longer hospital stay (25 vs. 17 days; p: 0.023). There were no significant differences in the development of primary graft disfunction or graft loss. Liver transplant survival and kidney survival were similar in both groups.

Conclusion

The use of elderly donors has not influenced the clinical evolution of liver and kidney transplants in our series. Older donors should no longer be considered suboptimal, because they offer a possibility for certain patients on the waiting list.
Literatur
3.
Zurück zum Zitat Gordon Burroughs S, Busuttil RW. Optimal utilization of extended hepatic grafts. Surg Today. 2009;39:746–51. CrossRef Gordon Burroughs S, Busuttil RW. Optimal utilization of extended hepatic grafts. Surg Today. 2009;39:746–51. CrossRef
4.
Zurück zum Zitat Lué A, Solanas E, Baptista P, et al. How important is donor age in liver transplantation? World J Gastroenterol. 2016;22:4966–76. CrossRef Lué A, Solanas E, Baptista P, et al. How important is donor age in liver transplantation? World J Gastroenterol. 2016;22:4966–76. CrossRef
5.
Zurück zum Zitat Moreso F, Seron D, Gil-Vernet S, et al. Donor age and delayed graft function. J Am Soc Nephrol. 2002;13:1067–72. Moreso F, Seron D, Gil-Vernet S, et al. Donor age and delayed graft function. J Am Soc Nephrol. 2002;13:1067–72.
6.
Zurück zum Zitat Dayoub JC, Cortese F, Anžič A, et al. The effects of donor age on organ transplants: a review and implications for aging research. Exp Gerontol. 2018;110:230–40. CrossRef Dayoub JC, Cortese F, Anžič A, et al. The effects of donor age on organ transplants: a review and implications for aging research. Exp Gerontol. 2018;110:230–40. CrossRef
7.
Zurück zum Zitat Díaz Jaime F, Berenguer M. Pushing the donor limits: deceased donor liver transplantation using organs from octogenarian donors. Liver Transpl. 2017;23(S1):S22–S6. CrossRef Díaz Jaime F, Berenguer M. Pushing the donor limits: deceased donor liver transplantation using organs from octogenarian donors. Liver Transpl. 2017;23(S1):S22–S6. CrossRef
8.
Zurück zum Zitat Miñambres E, Coll E, Duerto J, et al. Effect of an intensive lung donor-management protocol on lung transplantation outcomes. J Heart Lung Transplant. 2014;33:178–84. CrossRef Miñambres E, Coll E, Duerto J, et al. Effect of an intensive lung donor-management protocol on lung transplantation outcomes. J Heart Lung Transplant. 2014;33:178–84. CrossRef
9.
Zurück zum Zitat Ballesteros MA, Duerto Álvarez J, Martín-Penagos L, et al. Influence of specific thoracic donor therapy on kidney donation and long-term kidney graft survival. J Nephrol. 2017;30:869–75. CrossRef Ballesteros MA, Duerto Álvarez J, Martín-Penagos L, et al. Influence of specific thoracic donor therapy on kidney donation and long-term kidney graft survival. J Nephrol. 2017;30:869–75. CrossRef
10.
Zurück zum Zitat Miñambres E, Suberviola B, Dominguez-Gil B, et al. Improving the outcomes of organs obtained from controlled donation after circulatory death donors using abdominal normothermic regional perfusion. Am J Transplant. 2017;17:2165–72. CrossRef Miñambres E, Suberviola B, Dominguez-Gil B, et al. Improving the outcomes of organs obtained from controlled donation after circulatory death donors using abdominal normothermic regional perfusion. Am J Transplant. 2017;17:2165–72. CrossRef
11.
Zurück zum Zitat Miñambres E, Rubio JJ, Coll E, et al. Donation after circulatory death and its expansion in Spain. Curr Opin Organ Transplant. 2018;23(1):120–9. CrossRef Miñambres E, Rubio JJ, Coll E, et al. Donation after circulatory death and its expansion in Spain. Curr Opin Organ Transplant. 2018;23(1):120–9. CrossRef
12.
Zurück zum Zitat Suberviola B, Mons R, Ballesteros MA, et al. Excellent long-term outcome with lungs obtained from uncontrolled donation after circulatory death. Am J Transplant. 2019;19(4):1195–201. CrossRef Suberviola B, Mons R, Ballesteros MA, et al. Excellent long-term outcome with lungs obtained from uncontrolled donation after circulatory death. Am J Transplant. 2019;19(4):1195–201. CrossRef
13.
Zurück zum Zitat Hamar M, Selzner M. Ex-vivo machine perfusion for kidney preservation. Curr Opin Organ Transplant. 2018;23:369–74. CrossRef Hamar M, Selzner M. Ex-vivo machine perfusion for kidney preservation. Curr Opin Organ Transplant. 2018;23:369–74. CrossRef
14.
Zurück zum Zitat Nasralla D, Coussios CC, Mergental H, et al. A randomized trial of normothermic preservation in liver transplantation. Nature. 2018;557(7703):50–6. CrossRef Nasralla D, Coussios CC, Mergental H, et al. A randomized trial of normothermic preservation in liver transplantation. Nature. 2018;557(7703):50–6. CrossRef
16.
Zurück zum Zitat Singhal A, Sezginsoy B, Ghuloom AE, et al. Orthotopic liver transplant using allografts from geriatric population in the United States: Is there any age limit? Exp Clin Transplant. 2010;8:196–201. PubMed Singhal A, Sezginsoy B, Ghuloom AE, et al. Orthotopic liver transplant using allografts from geriatric population in the United States: Is there any age limit? Exp Clin Transplant. 2010;8:196–201. PubMed
17.
Zurück zum Zitat Ghinolfi D, Marti J, De Simone P, et al. Use of octogenarian donors for liver transplantation: a survival analysis. Am J Transplant. 2014;14:2062–71. CrossRef Ghinolfi D, Marti J, De Simone P, et al. Use of octogenarian donors for liver transplantation: a survival analysis. Am J Transplant. 2014;14:2062–71. CrossRef
18.
Zurück zum Zitat Rosengard BR, Feng S, Alfrey EJ, et al. Report of the Crystal City meeting to maximize the use of organs recovered from the cadaver donor. Am J Transplant. 2002;2:701–11. CrossRef Rosengard BR, Feng S, Alfrey EJ, et al. Report of the Crystal City meeting to maximize the use of organs recovered from the cadaver donor. Am J Transplant. 2002;2:701–11. CrossRef
19.
Zurück zum Zitat Meier-Kriesche HU, Cibrik DM, Ojo AO, et al. Interaction between donor and recipient age in determining the risk of chronic renal allograft failure. J Am Geriatr Soc. 2002;50:14–7. CrossRef Meier-Kriesche HU, Cibrik DM, Ojo AO, et al. Interaction between donor and recipient age in determining the risk of chronic renal allograft failure. J Am Geriatr Soc. 2002;50:14–7. CrossRef
20.
Zurück zum Zitat Stolyar AG, Budkar LN, Solodushkin SI, et al. Influence of factors associated with the deceased-donor on kidney transplant outcomes. Exp Clin Transplant. 2015;13(5):394–401. PubMed Stolyar AG, Budkar LN, Solodushkin SI, et al. Influence of factors associated with the deceased-donor on kidney transplant outcomes. Exp Clin Transplant. 2015;13(5):394–401. PubMed
21.
Zurück zum Zitat Tullius SG, Tran H, Guleria I, et al. The combination of donor and recipient age is critical in determining host immunoresponsiveness and renal transplant outcome. Ann Surg. 2010;252:662–74. PubMed Tullius SG, Tran H, Guleria I, et al. The combination of donor and recipient age is critical in determining host immunoresponsiveness and renal transplant outcome. Ann Surg. 2010;252:662–74. PubMed
22.
Zurück zum Zitat Molnar MZ, Streja E, Kovesdy CP, et al. Age and the associations of living donor and expanded criteria donor kidneys with kidney transplant outcomes. Am J Kidney Dis. 2012;59:841–8. CrossRef Molnar MZ, Streja E, Kovesdy CP, et al. Age and the associations of living donor and expanded criteria donor kidneys with kidney transplant outcomes. Am J Kidney Dis. 2012;59:841–8. CrossRef
23.
Zurück zum Zitat Mezrich JD, Pirsch JD, Fernandez LA, et al. Differential outcomes of expanded-criteria donor renal allografts according to recipient age. Clin J Am Soc Nephrol. 2012;7:1163–71. CrossRef Mezrich JD, Pirsch JD, Fernandez LA, et al. Differential outcomes of expanded-criteria donor renal allografts according to recipient age. Clin J Am Soc Nephrol. 2012;7:1163–71. CrossRef
24.
Zurück zum Zitat Ojo AO, Hanson JA, Meier-Kriesche H, et al. Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and wait-listed transplant candidates. J Am Soc Nephrol. 2001;12:589–97. PubMed Ojo AO, Hanson JA, Meier-Kriesche H, et al. Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and wait-listed transplant candidates. J Am Soc Nephrol. 2001;12:589–97. PubMed
25.
Zurück zum Zitat Arrieta J. Evaluación económica del tratamiento sustitutivorenal (hemodiálisis, diálisis peritoneal y trasplante) en España. Nefrologia. 2010;1(Supl Ext 1):37–47. Arrieta J. Evaluación económica del tratamiento sustitutivorenal (hemodiálisis, diálisis peritoneal y trasplante) en España. Nefrologia. 2010;1(Supl Ext 1):37–47.
26.
Zurück zum Zitat Singbartl K, Murugan R, Kaynar AM, et al. Intensivist-led management of brain-dead donors is associated with an increase in organ recovery for transplantation. Am J Transplant. 2011;11:1517–21. CrossRef Singbartl K, Murugan R, Kaynar AM, et al. Intensivist-led management of brain-dead donors is associated with an increase in organ recovery for transplantation. Am J Transplant. 2011;11:1517–21. CrossRef
Metadaten
Titel
Impact of the elderly donor on an abdominal organ transplantation program
verfasst von
MD, PhD María Ángeles Ballesteros
MD, PhD Borja Suberviola
MD Lara Belmar Vega
MD Roberto Fernández-Santiago
MD Sandra Campos Fernández
MD, PhD Juan Carlos Ruiz San Millán
MD, PhD Eduardo Miñambres
Publikationsdatum
24.04.2020
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 5/2020
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-020-00637-0