de Fijter, Johan and Dreyer, Geertje and Mallat, Marko and Budde, Klemens and Pratschke, Johann and Klempnauer, Jurgen and Zeier, Martin and Arns, Wolfgang and Hugo, Christian and Rump, Lars-Christian and Hauser, Ingeborg and Schenker, Peter and Schiffer, Mario and Grimm, Marc-Oliver and Kliem, Volker and Olbricht, Christoph J. and Pisarski, Przemyslaw and Banas, Bernhard and Suwelack, Barbara and Hakenberg, Oliver and Berlakovich, Gabriela and Schneeberger, Stefan and van de Wetering, Jacqueline and Berger, Stefan and Bemelman, Frederike and Kuypers, Dirk and Heidt, Sebastiaan and Rahmel, Axel and Claas, Frans and Peeters, Patrick and Oberbauer, Rainer and Heemann, Uwe and Kramer, Bernhard K. (2023) A paired-kidney allocation study found superior survival with HLA-DR compatible kidney transplants in the Eurotransplant Senior Program. KIDNEY INTERNATIONAL, 104 (3). pp. 552-561. ISSN 0085-2538, 1523-1755
Full text not available from this repository. (Request a copy)Abstract
The Eurotransplant Senior Program (ESP) has expedited the chance for elderly patients with kidney failure to receive a timely transplant. This current study evaluated survival parameters of kidneys donated after brain death with or without matching for HLA-DR antigens. This cohort study evaluated the period within ESP with paired allocation of 675 kidneys from donors 65 years and older to transplant candidates 65 years and older, the first kidney to 341 patients within the Eurotransplant Senior DR-compatible Program and 334 contralateral kidneys without (ESP) HLADR antigen matching. We used Kaplan-Meier estimates and competing risk analysis to assess all cause mortality and kidney graft failure, respectively. The log-rank test and Cox proportional hazards regression were used for comparisons. Within ESP, matching for HLA-DR antigens was associated with a significantly lower five-year risk of mortality (hazard ratio 0.71; 95% confidence interval 0.530.95) and significantly lower cause-specific hazards for kidney graft failure and return to dialysis at one year (0.55; 0.35-0.87) and five years (0.73; 0.53-0.99) post-transplant. Allocation based on HLA-DR matching resulted in longer cold ischemia (mean difference 1.00 hours; 95% confidence interval: 0.32-1.68) and kidney offers with a significantly shorter median dialysis vintage of 2.4 versus 4.1 yrs. in ESP without matching. Thus, our allocation based on HLA-DR matching improved five-year patient and kidney allograft survival. Hence, our paired allocation study suggests a superior outcome of HLA-DR matching in the context of old-for-old kidney transplantation.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RENAL-TRANSPLANTATION; RECIPIENTS; DONOR; OLDER; RISK; AGE; MORTALITY; TIME; REGISTRY; QUALITY; allocation; Eurotransplant Senior Program; histocompatibility; HLA-DR matching; kidney transplantation; old-for-old allocation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Nephrologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 30 Jan 2024 10:11 |
| Last Modified: | 30 Jan 2024 10:11 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60917 |
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