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Outcome of live and deceased donor renal transplantation in patients aged ≥55 years: A single-center experience.

Kute VB, Vanikar AV, Shah PR, Gumber MR, Patel HV, Modi PR, Rizvi SJ, Shah VR, Modi MP, Kanodia KV, Trivedi HL - Indian J Nephrol (2014)

Bottom Line: There were 12.6% biopsy proven acute rejection (BPAR) episodes and 12.6% patients were lost, mainly due to infections.There were 12.5% BPAR episodes and 25% of patients were lost, mainly due to infections.RTx in ESRD (≥55 years) patients has acceptable patient and graft survival if found to have cardiac fitness and therefore should be encouraged.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India.

ABSTRACT
Renal transplantation (RTx) has now become an accepted therapeutic modality of choice for elderly ESRD patients. This single-center study was undertaken to evaluate the outcome of RTx in ESRD patients ≥55 years. A total of 103 patients underwent RTx 79 living related living donors [LD], 24 deceased donors [DD]) at our center. Post-transplant immunosuppression consisted of calcineurin inhibitor-based regimen. The mean donor age was 58.3 years in the LD group and 59.5 years in the DD group. Male recipients constituted 92% in LD and 75% in DD group. In living donor renal transplantation, 1- and 5-year patient survival was 93% and 83.3% respectively and death-censored graft survival was 97.3% and 92.5% respectively. There were 12.6% biopsy proven acute rejection (BPAR) episodes and 12.6% patients were lost, mainly due to infections. In deceased donor renal transplantation, 1- and 5-year patient survival was 79.1% and 74.5% respectively and death-censored graft survival was 95.8% and 85.1% respectively. There were 12.5% BPAR episodes and 25% of patients were lost, mainly due to infections. RTx in ESRD (≥55 years) patients has acceptable patient and graft survival if found to have cardiac fitness and therefore should be encouraged.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier patient survival curves in living versus deceased donors
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Figure 1: Kaplan-Meier patient survival curves in living versus deceased donors

Mentions: Over a mean follow-up of 3.0 ± 1.5 years, 1-and 5-year patient survivals were 93% and 83.3% and death-censored graft survival was 97.3% and 92.5% for 1 and 5 years, respectively. A total of 12.6% (n = 10) patients were lost, mainly due to infections (n = 8) (CMV disease [n = 1], tuberculosis [n = 1], fungal infection [n = 1], pneumonia with acute respiratory distress [n = 3], hepatic encephalopathy secondary to chronic viral hepatitis [n = 1]), CVAs (n = 1), cardiovascular disease (CVD) (n = 1) and post-transplant lymphoproliferative disorder (n = 1)). There were 12.6% (n = 10) biopsy proven acute rejection (BPAR) episodes, out of which 5% (n = 4) were acute B-cell mediated rejections acute humoral rejection (AHR), 1.2% (n = 1) acute T-cell mediated rejections (ATR), 6.3% (n = 5) were combined acute T + B-cell mediated rejections and 1.2% (n = 1) had unexplained interstitial fibrosis with tubular atrophy (IFTA). Most of them (n = 8) recovered after anti-rejection therapy (ART); however two patients died from bacterial or viral infections within 6 months of ART, whereas IFTA eventually led to graft loss. Survival rates are shown in Kaplan-Meier curves Figure 1 (Group 1 LDs and Group 2 DDs) and Figure 2.


Outcome of live and deceased donor renal transplantation in patients aged ≥55 years: A single-center experience.

Kute VB, Vanikar AV, Shah PR, Gumber MR, Patel HV, Modi PR, Rizvi SJ, Shah VR, Modi MP, Kanodia KV, Trivedi HL - Indian J Nephrol (2014)

Kaplan-Meier patient survival curves in living versus deceased donors
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927204&req=5

Figure 1: Kaplan-Meier patient survival curves in living versus deceased donors
Mentions: Over a mean follow-up of 3.0 ± 1.5 years, 1-and 5-year patient survivals were 93% and 83.3% and death-censored graft survival was 97.3% and 92.5% for 1 and 5 years, respectively. A total of 12.6% (n = 10) patients were lost, mainly due to infections (n = 8) (CMV disease [n = 1], tuberculosis [n = 1], fungal infection [n = 1], pneumonia with acute respiratory distress [n = 3], hepatic encephalopathy secondary to chronic viral hepatitis [n = 1]), CVAs (n = 1), cardiovascular disease (CVD) (n = 1) and post-transplant lymphoproliferative disorder (n = 1)). There were 12.6% (n = 10) biopsy proven acute rejection (BPAR) episodes, out of which 5% (n = 4) were acute B-cell mediated rejections acute humoral rejection (AHR), 1.2% (n = 1) acute T-cell mediated rejections (ATR), 6.3% (n = 5) were combined acute T + B-cell mediated rejections and 1.2% (n = 1) had unexplained interstitial fibrosis with tubular atrophy (IFTA). Most of them (n = 8) recovered after anti-rejection therapy (ART); however two patients died from bacterial or viral infections within 6 months of ART, whereas IFTA eventually led to graft loss. Survival rates are shown in Kaplan-Meier curves Figure 1 (Group 1 LDs and Group 2 DDs) and Figure 2.

Bottom Line: There were 12.6% biopsy proven acute rejection (BPAR) episodes and 12.6% patients were lost, mainly due to infections.There were 12.5% BPAR episodes and 25% of patients were lost, mainly due to infections.RTx in ESRD (≥55 years) patients has acceptable patient and graft survival if found to have cardiac fitness and therefore should be encouraged.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India.

ABSTRACT
Renal transplantation (RTx) has now become an accepted therapeutic modality of choice for elderly ESRD patients. This single-center study was undertaken to evaluate the outcome of RTx in ESRD patients ≥55 years. A total of 103 patients underwent RTx 79 living related living donors [LD], 24 deceased donors [DD]) at our center. Post-transplant immunosuppression consisted of calcineurin inhibitor-based regimen. The mean donor age was 58.3 years in the LD group and 59.5 years in the DD group. Male recipients constituted 92% in LD and 75% in DD group. In living donor renal transplantation, 1- and 5-year patient survival was 93% and 83.3% respectively and death-censored graft survival was 97.3% and 92.5% respectively. There were 12.6% biopsy proven acute rejection (BPAR) episodes and 12.6% patients were lost, mainly due to infections. In deceased donor renal transplantation, 1- and 5-year patient survival was 79.1% and 74.5% respectively and death-censored graft survival was 95.8% and 85.1% respectively. There were 12.5% BPAR episodes and 25% of patients were lost, mainly due to infections. RTx in ESRD (≥55 years) patients has acceptable patient and graft survival if found to have cardiac fitness and therefore should be encouraged.

No MeSH data available.


Related in: MedlinePlus