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

Ron Shapiro, Carlo Vivas, Velma P. Scantlebury, Mark L. Jordan, H. Albin Gritsch, Joel Neugarten, Jerry Mccauley, Parmjeet Randhawa, William Irish, John J. Fung, Thomas Hakala, Richard L. Simmons, Thomas E. Starzl

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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.

Original languageEnglish (US)
Pages (from-to)1242-1246
Number of pages5
JournalTransplantation
Volume62
Issue number9
StatePublished - Nov 15 1996

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Tacrolimus
Immunosuppression
Tissue Donors
Kidney
Survival Rate
Graft Survival
Pediatrics
Creatinine
Serum
Kidney Transplantation
Incidence

ASJC Scopus subject areas

  • Immunology
  • Transplantation

Cite this

Shapiro, R., Vivas, C., Scantlebury, V. P., Jordan, M. L., Gritsch, H. A., Neugarten, J., ... Starzl, T. E. (1996). "Suboptimal" kidney donors: The experience with tacrolimus-based immunosuppression. Transplantation, 62(9), 1242-1246.

"Suboptimal" kidney donors : The experience with tacrolimus-based immunosuppression. / Shapiro, Ron; Vivas, Carlo; Scantlebury, Velma P.; Jordan, Mark L.; Gritsch, H. Albin; Neugarten, Joel; Mccauley, Jerry; Randhawa, Parmjeet; Irish, William; Fung, John J.; Hakala, Thomas; Simmons, Richard L.; Starzl, Thomas E.

In: Transplantation, Vol. 62, No. 9, 15.11.1996, p. 1242-1246.

Research output: Contribution to journalArticle

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, TE 1996, '"Suboptimal" kidney donors: The experience with tacrolimus-based immunosuppression', Transplantation, vol. 62, no. 9, pp. 1242-1246.
Shapiro R, Vivas C, Scantlebury VP, Jordan ML, Gritsch HA, Neugarten J et al. "Suboptimal" kidney donors: The experience with tacrolimus-based immunosuppression. Transplantation. 1996 Nov 15;62(9):1242-1246.
Shapiro, Ron ; Vivas, Carlo ; Scantlebury, Velma P. ; Jordan, Mark L. ; Gritsch, H. Albin ; Neugarten, Joel ; Mccauley, Jerry ; Randhawa, Parmjeet ; Irish, William ; Fung, John J. ; Hakala, Thomas ; Simmons, Richard L. ; Starzl, Thomas E. / "Suboptimal" kidney donors : The experience with tacrolimus-based immunosuppression. In: Transplantation. 1996 ; Vol. 62, No. 9. pp. 1242-1246.
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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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