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"Suboptimal" kidney donors: The experience with tacrolimus-based immunosuppression

Shapiro, R and Vivas, C and Scantlebury, VP and Jordan, ML and Gritsch, HA and Neugarten, J and Mccauley, J and Randhawa, P and Irish, W and Fung, JJ and Hakala, T and Simmons, RL and Starzl, TE (1996) "Suboptimal" kidney donors: The experience with tacrolimus-based immunosuppression. Transplantation, 62 (9). 1242 - 1246. ISSN 0041-1337

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Abstract

Female, pediatric, and older donors have been associated with inferior graft survival after renal transplantation. We analyzed these three subgroups in 397 patients receiving tacrolimus-based immunosuppression. There were no differences in recipient age, incidence of retransplantation, or percentage of sensitized patients. Female donors, compared with male donors, were associated with comparable 1- and 3-year patient survival rates (96% and 93% vs. 95% and 92%, respectively) and comparable 1- and 3-year graft survival rates (90% and 80% vs. 88% and 81%, respectively). Renal function was also similar. Recipients of pediatric en bloc kidneys, when compared with recipients of other cadaveric kidneys, also had comparable 1- and 3-year patient survival rates (94% and 94% vs. 95% and 91%, respectively) and comparable 1- and 3-year graft survival rates (84% and 84% vs. 89% and 79%, respectively). Renal function was better in recipients of en bloc kidneys, with a mean serum creatinine level of 1.4±1.8 mg/dl vs. 2.0±1.5 mg/dl (P=0.01). In contrast to the first two subgroups, donors over 60 years of age, when compared with donors under 60 years of age, were associated with worse 1- and 3-year patient survival rates (88% and 80% vs. 96% and 94%, respectively; P < 0.03) and worse 1- and 3-year graft survival rates (74% and 62% vs. 91% and 83%, respectively; P < 0.0001). Renal function was worse in the older donor group, with a serum creatinine level of 2.7±1.2 mg/ml vs. 1.9±1.5 mg/dl (P=0.01). We conclude that, under tacrolimus-based immunosuppression, kidneys from female or very young pediatric donors are not associated with adverse outcomes, whereas kidneys from donors over 60 years of age are associated with inferior outcomes.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Shapiro, R
Vivas, C
Scantlebury, VP
Jordan, ML
Gritsch, HA
Neugarten, J
Mccauley, J
Randhawa, P
Irish, W
Fung, JJ
Hakala, T
Simmons, RL
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 15 November 1996
Date Type: Publication
Journal or Publication Title: Transplantation
Volume: 62
Number: 9
Page Range: 1242 - 1246
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1337
Other ID: uls-drl:31735062133412, Starzl CV No. 1877
Date Deposited: 08 Apr 2010 17:32
Last Modified: 14 Oct 2017 05:57
URI: http://d-scholarship.pitt.edu/id/eprint/5263

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