TY - JOUR
T1 - Extension of the organ pool in kidney transplantation
T2 - First year experience of the Israel Transplant Center
AU - Mor, E.
AU - Michowiz, R.
AU - Ashkenazi, T.
AU - Shabtai, E.
AU - Nakache, R.
AU - Eid, A.
AU - Hoffman, A.
AU - Mizrahi, S.
AU - Shabtai, M.
AU - Shapira, Z.
PY - 2000
Y1 - 2000
N2 - Background: Over a 12 month period, the Israel Transplant Center doubled the number of donors by assigning a nurse coordinator to each of 22 hospitals around the country and by using kidneys from elderly donors. Objective: To evaluate the impact of our 'marginal donors' policy on the results immediately following transplantation. Methods: Between October 1997 and September 1998, 140 cadaveric kidney transplantations from 72 donors were performed in Israel. We defined two groups of recipients: Patients with immediate graft function and patients with either delayed graft function requiring > 1 week of dialysis post-transplant or with primary graft non-function. We compared the following parameters between groups: Donor and recipient age and gender, cause of donor's death, length of stay in the intensive care unit, vasopressor dosage and creatinine levels before harvesting, cold ischemic time, and the number of recipient grafts. Results: There were 102 recipients (72.8%) with immediate graft function and 38 with either PNF (n = 13, 9.3%) or DGF (n = 25, 17.9%). On regression analysis, donor age >50 year and retransplantation were significant risk factors for PNF or DGF (odds ratio 4.4 and 2.8, respectively). Of the 56 kidneys from donors >50 years old, 21 (37.5%) developed either PNF (n=9) or DGF (n=12). Conclusions: We conclude that kidneys from donors over age 50 are at increased risk for graft non-function or delayed function. Better assessment of functional capacity of kidneys from 'aged' donors may help to choose appropriate donors from that pool.
AB - Background: Over a 12 month period, the Israel Transplant Center doubled the number of donors by assigning a nurse coordinator to each of 22 hospitals around the country and by using kidneys from elderly donors. Objective: To evaluate the impact of our 'marginal donors' policy on the results immediately following transplantation. Methods: Between October 1997 and September 1998, 140 cadaveric kidney transplantations from 72 donors were performed in Israel. We defined two groups of recipients: Patients with immediate graft function and patients with either delayed graft function requiring > 1 week of dialysis post-transplant or with primary graft non-function. We compared the following parameters between groups: Donor and recipient age and gender, cause of donor's death, length of stay in the intensive care unit, vasopressor dosage and creatinine levels before harvesting, cold ischemic time, and the number of recipient grafts. Results: There were 102 recipients (72.8%) with immediate graft function and 38 with either PNF (n = 13, 9.3%) or DGF (n = 25, 17.9%). On regression analysis, donor age >50 year and retransplantation were significant risk factors for PNF or DGF (odds ratio 4.4 and 2.8, respectively). Of the 56 kidneys from donors >50 years old, 21 (37.5%) developed either PNF (n=9) or DGF (n=12). Conclusions: We conclude that kidneys from donors over age 50 are at increased risk for graft non-function or delayed function. Better assessment of functional capacity of kidneys from 'aged' donors may help to choose appropriate donors from that pool.
KW - Delayed function
KW - Elderly donors
KW - Kidney transplantation
KW - Primary non-function
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AN - SCOPUS:0033839166
SN - 1565-1088
VL - 2
SP - 302
EP - 305
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 4
ER -