Benefits of Living Over Deceased Donor Kidney Transplantation in Elderly Recipients. A Propensity Score Matched Analysis of a Large European Registry Cohort

Although kidney transplantation from living donors (LD) offers better long-term results than from deceased donors (DD), elderly recipients are less likely to receive LD transplants than younger ones. We analyzed renal transplant outcomes from LD versus DD in elderly recipients with a propensity-matched score. This retrospective, observational study included the first single kidney transplants in recipients aged ≥65 years from two European registry cohorts (2013-2020, n = 4,257). Recipients of LD (n = 408), brain death donors (BDD, n = 3,072), and controlled cardiocirculatory death donors (cDCD, n = 777) were matched for donor and recipient age, sex, dialysis time and recipient diabetes. Major graft and patient outcomes were investigated. Unmatched analyses showed that LD recipients were more likely to be transplanted preemptively and had shorter dialysis times than any DD type. The propensity score matched Cox's regression analysis between LD and BDD (387-pairs) and LD and cDCD (259-pairs) revealing a higher hazard ratio for graft failure with BDD (2.19 [95% CI: 1.16-4.15], <i>p</i> = 0.016) and cDCD (3.38 [95% CI: 1.79-6.39], <i>p</i> < 0.001). One-year eGFR was higher in LD transplants than in BDD and cDCD recipients. In elderly recipients, LD transplantation offers superior graft survival and renal function compared to BDD or cDCD. This strategy should be further promoted to improve transplant outcomes.

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Publication Details

Journal
Transplant International
Published
2024-08-23
DOI
https://doi.org/10.3389/ti.2024.13452
Citations
9
Primary Topic
Renal Transplantation Outcomes and Treatments
Type
article
Field-Weighted Citation Impact
4.57

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article

Benefits of Living Over Deceased Donor Kidney Transplantation in Elderly Recipients. A Propensity Score Matched Analysis of a Large European Registry Cohort

Jordi Comas, Anders Åsberg, Jaume Tort, Maarten Naesens et al.
9 citations
Transplant International
Renal Transplantation Outcomes and Treatments
4.57
article

Benefits of Living Over Deceased Donor Kidney Transplantation in Elderly Recipients. A Propensity Score Matched Analysis of a Large European Registry Cohort

Jordi Comas, Anders Åsberg, Jaume Tort, Maarten Naesens, Oriol Bestard, A. Vilà, Emma Arcos, Magali Giral, Dirk Kuypers, Anna Manonelles, María José Pérez‐Sáez, Néstor Toapanta, Francesc Moreso, Carme Facundo, Ignacio Revuelta
article en
9 citations

Abstract

Although kidney transplantation from living donors (LD) offers better long-term results than from deceased donors (DD), elderly recipients are less likely to receive LD transplants than younger ones. We analyzed renal transplant outcomes from LD versus DD in elderly recipients with a propensity-matched score. This retrospective, observational study included the first single kidney transplants in recipients aged ≥65 years from two European registry cohorts (2013-2020, n = 4,257). Recipients of LD (n = 408), brain death donors (BDD, n = 3,072), and controlled cardiocirculatory death donors (cDCD, n = 777) were matched for donor and recipient age, sex, dialysis time and recipient diabetes. Major graft and patient outcomes were investigated. Unmatched analyses showed that LD recipients were more likely to be transplanted preemptively and had shorter dialysis times than any DD type. The propensity score matched Cox's regression analysis between LD and BDD (387-pairs) and LD and cDCD (259-pairs) revealing a higher hazard ratio for graft failure with BDD (2.19 [95% CI: 1.16-4.15], <i>p</i> = 0.016) and cDCD (3.38 [95% CI: 1.79-6.39], <i>p</i> < 0.001). One-year eGFR was higher in LD transplants than in BDD and cDCD recipients. In elderly recipients, LD transplantation offers superior graft survival and renal function compared to BDD or cDCD. This strategy should be further promoted to improve transplant outcomes.

Transplant InternationalVol. 37
Hebron University (PS), Oslo University Hospital (NO), Inserm (FR), University of Oslo (NO), Organización Nacional de Trasplantes (ES), Bellvitge University Hospital (ES), Institut d'Investigació Biomédica de Bellvitge (ES), Vall d'Hebron Institut de Recerca (ES), Institut de Transplantation Urologie en Nephrologie (FR), Hospital Clínic de Barcelona (ES), Vall d'Hebron Hospital Universitari (ES), Metabolism and Renal Physiology (FR), Hospital Del Mar (ES), Puigvert Foundation (ES), Hospital Universitari Germans Trias i Pujol (ES), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), Center for Research in Transplantation and Translational Immunology, Universitat de Barcelona (ES), Nantes Université (FR), KU Leuven (BE)
European Commission, Instituto de Salud Carlos III, European Regional Development Fund, European Social Fund
Good health and well-being
Openalex Percentile: Top 4%
Renal Transplantation Outcomes and Treatments
4.57
DOIOpen Access PDFOpenAlex
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