Publication:
Kidney transplants from elderly donors: the experience of a reference center in Croatia

dc.contributor.coauthorZivcic-Cosic, Stela
dc.contributor.coauthorDohler, Bernd
dc.contributor.coauthorKatalini, Natasa
dc.contributor.coauthorMarki, Dean
dc.contributor.coauthorOrli, Lidija
dc.contributor.coauthorRacki, Sanjin
dc.contributor.coauthorSpanjol, Josip
dc.contributor.coauthorTrobonjaca, Zlatko
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorSüsal, Caner
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-10T00:04:42Z
dc.date.issued2022
dc.description.abstractObjectives: Our country Croatia is among the global leaders regarding deceased donation rates, yet we are facing organ shortage and concurrently a sharp decline in our acceptance rates for kidney offers. To reevaluate our organ acceptance policy, we retrospectively analyzed the factors that influenced the posttransplant outcomes of kidneys from elderly deceased donors at our center during a 20-year period and the changes to our organ acceptance criteria during Eurotransplant membership. Materials and Methods: We studied all kidney transplants from donors >= 60 years old during the two 5-year episodes of Eurotransplant membership from 2007 to 2017 (period II and period III) and compared those data to data from the decade before Eurotransplant membership (period I, 1997-2007). Differences in acceptance rates and reasons for the decline of kidney offers between the two 5-year periods of Eurotransplant membership were analyzed. Results: In period I, 14.1% of all kidney allografts were obtained from donors >= 60 years old; in period II and period III the rates were nearly 2-fold higher (27.0% and 25.7%, respectively; P= .007 and P= .008). During the first 5-year period of Eurotransplant membership (period II), we accepted significantly more grafts from marginal donors with a higher number of human leukocyte antigen mismatches compared with period I. Consequently, the 3-month survival rate of kidneys from donors >= 60 years old dropped from 91.1% to as low as 74.2% (P = .034). After application of morestringent human leukocyte antigen matching, especially in human leukocyte antigen DR, and morestringent donor acceptance criteria in period III, graft survival improved to 91.1%. Conclusions: Our experience indicates that careful selection of kidneys from elderly deceased donors and allocation to human leukocyte antigen-matched recipients is important to improve transplant outcomes.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue1
dc.description.openaccessNO
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume20
dc.identifier.doi10.6002/ect.2021.0366
dc.identifier.eissn2146-8427
dc.identifier.issn1304-0855
dc.identifier.quartileQ4
dc.identifier.scopus2-s2.0-85123201873
dc.identifier.urihttps://doi.org/10.6002/ect.2021.0366
dc.identifier.urihttps://hdl.handle.net/20.500.14288/16318
dc.identifier.wos746007600011
dc.keywordsGraft Survival
dc.keywordsHistocompatibility
dc.keywordsKidney Allograft Surgical Complications
dc.keywordsGraft-Survival
dc.keywordsCriteria
dc.keywordsRecipients
dc.keywordsOlder
dc.keywordsTime
dc.keywordsAge
dc.language.isoeng
dc.publisherBaskent Univ
dc.relation.ispartofExperimental and Clinical Transplantation
dc.subjectTransplantation
dc.titleKidney transplants from elderly donors: the experience of a reference center in Croatia
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorSüsal, Caner
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
local.publication.orgunit2School of Medicine
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