Evaluation of 84 elderly donors in renal transplantation

Clinical Transplantation
Paolo RigottiErmanno Ancona

Abstract

The use of elderly donors (ED) and dual kidney transplantation (DKT) procedures have become common in clinical practice. A correct evaluation of kidneys from ED is crucial to avoid unsuccessful transplantation or the use of DKT when a single transplant (ST) would be equally successful. The aim of this investigation was to assess the role of renal biopsy (RB) in the assessment of kidneys from ED. A total of 84 ED aged > or = 60 yr were evaluated. In 19 cases, the kidneys were not used, mainly because of atherosclerotic vascular lesions. A histological score (HS) from 0 to 12 was awarded, considering the proportion of glomerulosclerosis, tubular atrophy, interstitial fibrosis, and arterial and arteriolar narrowing. On the basis of the HS, 37 donors were selected for 40 ST and 21 for DKT, three were discarded. All recipients received triple-drug therapy based on calcineurin inhibitors, mycophenolate mofetil and steroids. Primary non-function was observed in three of 40 ST and one of 21 DKT. Acute tubular necrosis occurred in 22/40 ST and in 11/21 DKT. Acute rejection occurred in 16/40 ST and four of 21 DKT. Renal function was satisfactory in both groups, with 1-yr S-Cr = 171 micromol/L and 137 micromol/L, respectively in the ST an...Continue Reading

References

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Citations

Sep 18, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·UNKNOWN European Renal Best Practice Transplantation Guideline Development Group
Jun 15, 2006·Transplant International : Official Journal of the European Society for Organ Transplantation·Burcin EkserPaolo Rigotti
Feb 17, 2007·Clinical Transplantation·Lucrezia FurianPaolo Rigotti
Jul 20, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·B EkserP Rigotti

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