TY - JOUR
T1 - Donor age, cold ischemia time, and delayed graft function
AU - Helanterä, Ilkka
AU - Ibrahim, Hassan N.
AU - Lempinen, Marko
AU - Finne, Patrik
N1 - Funding Information:
Dr. Finne reports personal fees from Baxter, outside the submitted work. Dr. Helanterä reports grants from Finska Läkaresällskapet, duringtheconductofthestudy;personalfeesfromNovartis,outside
Funding Information:
This study was supported by Finska Läkaresällskapet and Finnish Government Research Funds for Health Sciences (Valtion rahoitus yliopistotasoiseen terveyden tutkimukseen) grant TYH2019214 (to Dr. Helanterä).
Publisher Copyright:
© 2020 by the American Society of Nephrology.
PY - 2020/6/8
Y1 - 2020/6/8
N2 - Background and objectives Increased donor age is one of the most important risk factors for delayed graft function (DGF), and previous studies suggest that the harmful effect of cold ischemia time is increased in kidneys from older donors. Our aim Was to study the association of increased donor age and cold ischemia time With the risk of delayed graft function in a large cohort kidney transplants from the current era. Design, setting, participants, & measurements The Scientific Registry of Transplant Recipients Was used for this observational, retrospective registry analysis to identify all deceased donor kidney transplantations in the United States between 2010 and September 2018, Who Were on dialysis pretransplantation (n=90,810). The association of donor age and cold ischemia time With the risk of DGF Was analyzed in multivariable models adjusted for recipient characteristics (age, race, sex, diabetes, calculated panel-reactive antibodies, pretransplant dialysis duration) and donor characteristics (cause of death, sex,race, body mass index, creatinine, donation after circulatorydeath status, history of hypertension, and HLA mismatch). Results Cold ischemia time and donor age Were independently associated With the risk of DGF, but the risk of DGF Was not statistically significantly lower in donor age categories between 50 and 64 years, compared With donors ≥65 years. The harmful association of cold ischemia time Was not higher in kidneys from older donors in any age category, not even among donation after circulatory death donors. When donor risk Was assessed With kidney donor profile index, although a statistically significant interaction With cold ischemia time Was found, no practically meaningful increase in cold-ischemia susceptibility of kidneys With a high kidney donor profile index Was found. Conclusions We Were unable to demonstrate an association between donor age and DGF. The association of longer cold ischemia time With the risk of DGF Was not magnified in older or more marginal donors.
AB - Background and objectives Increased donor age is one of the most important risk factors for delayed graft function (DGF), and previous studies suggest that the harmful effect of cold ischemia time is increased in kidneys from older donors. Our aim Was to study the association of increased donor age and cold ischemia time With the risk of delayed graft function in a large cohort kidney transplants from the current era. Design, setting, participants, & measurements The Scientific Registry of Transplant Recipients Was used for this observational, retrospective registry analysis to identify all deceased donor kidney transplantations in the United States between 2010 and September 2018, Who Were on dialysis pretransplantation (n=90,810). The association of donor age and cold ischemia time With the risk of DGF Was analyzed in multivariable models adjusted for recipient characteristics (age, race, sex, diabetes, calculated panel-reactive antibodies, pretransplant dialysis duration) and donor characteristics (cause of death, sex,race, body mass index, creatinine, donation after circulatorydeath status, history of hypertension, and HLA mismatch). Results Cold ischemia time and donor age Were independently associated With the risk of DGF, but the risk of DGF Was not statistically significantly lower in donor age categories between 50 and 64 years, compared With donors ≥65 years. The harmful association of cold ischemia time Was not higher in kidneys from older donors in any age category, not even among donation after circulatory death donors. When donor risk Was assessed With kidney donor profile index, although a statistically significant interaction With cold ischemia time Was found, no practically meaningful increase in cold-ischemia susceptibility of kidneys With a high kidney donor profile index Was found. Conclusions We Were unable to demonstrate an association between donor age and DGF. The association of longer cold ischemia time With the risk of DGF Was not magnified in older or more marginal donors.
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U2 - 10.2215/CJN.13711119
DO - 10.2215/CJN.13711119
M3 - Article
C2 - 32404337
AN - SCOPUS:85086920634
VL - 15
SP - 813
EP - 821
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
SN - 1555-9041
IS - 6
ER -