Evaluation of the Eurotransplant Senior Program. The Results of the First Year

https://doi.org/10.1034/j.1600-6143.2002.20713.xGet rights and content
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On 4 January 1999, the Eurotransplant Senior Program (ESP) was implemented within the Eurotransplant kidney allocation scheme.

Patients and Methods: Kidneys obtained from donors aged over 65 years of age (65 +) were allocated to a selected group of nonimmunized 65 + patients undergoing their first transplant. All transplants were performed locally to minimize cold‐ischemic time. All transplants performed with kidneys from elderly donors that were allocated via ESP (ESP group) were compared to transplants performed with similar kidneys allocated via the standard renal allocation system (control group). Initial kidney function and 1‐year graft outcome were assessed.

Results: In 1999, 227 ESP and 102 control transplants were performed. The duration of cold‐ischemic time was 12 and 19 h for the ESP and control groups, respectively. No rejection episodes occurred in 60% and 67% of the ESP patients and controls, respectively, while a direct kidney function was observed in 59% of ESP and 49% of control patients. The 1‐year graft survival rates, censoring for graft losses due to deaths in patients with functioning grafts, were 86% and 79%, respectively.

Conclusion: An old‐for‐old renal allocation algorithm can be successful provided that risk factors, such as cold‐ischemic time, are reduced.

Keywords

Age matching
cadaveric renal transplantation
expanded criteria donor
old-for-old allocation
waiting list management

Abbreviations

ESP
Eurotransplant senior program
PNF
Permanent nonfunction
EI
ESP kidney transplant with initial function
ED
ESP kidney transplant with delayed graft function
EN
ESP kidney transplant with permanent nonfunction
CI
Control kidney transplant with initial function
CD
Control kidney transplant with delayed graft function
CN
Control kidney transplant with permanent nonfunction
MOF
Multi-organ failure
SAB
Subarachnoidal bleeding
CVA
Cerebrovascular accident
eci
e causa ignota

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Eurotransplant is an organ exchange organization in which transplant centers, donor hospitals and tissue-typing centers in Austria, Belgium, Germany, Luxembourg, the Netherlands and Slovenia collaborate.(http://www.eurotransplant.org)