Characterizing the risk of human leukocyte antigen-incompatible living donor kidney transplantation in older recipients.

Authors

• Jane J Long
• Jennifer D Motter
• Kyle R Jackson
• Jennifer Chen
• Babak J Orandi
• Robert A Montgomery
• Mark D Stegall
• Stanley C Jordan
• Enrico Benedetti
• Ty B Dunn
• Lloyd E Ratner
• Sandip Kapur
• Ronald P Pelletier
• John P Roberts
• Marc L Melcher
• Pooja Singh
• Debra L Sudan
• Marc P Posner
• Jose M El-Amm
• Ron Shapiro
• Matthew Cooper
• Jennifer E Verbesey
• George S Lipkowitz
• Michael A Rees
• Christopher L Marsh
• Bashir R Sankari
• David A Gerber
• Jason R Wellen
• Adel Bozorgzadeh
• A Osama Gaber
• Eliot C Heher
• Francis L Weng
• Arjang Djamali
• J Harold Helderman
• Beatrice P Concepcion
• Kenneth L Brayman
• Jose Oberholzer
• Tomasz Kozlowski
• Karina Covarrubias
• Allan B Massie
• Mara A McAdams-DeMarco
• Dorry L Segev
• Jacqueline M Garonzik-Wang

Publication/Presentation Date

12-1-2023

Abstract

Older compatible living donor kidney transplant (CLDKT) recipients have higher mortality and death-censored graft failure (DCGF) compared to younger recipients. These risks may be amplified in older incompatible living donor kidney transplant (ILDKT) recipients who undergo desensitization and intense immunosuppression. In a 25-center cohort of ILDKT recipients transplanted between September 24, 1997, and December 15, 2016, we compared mortality, DCGF, delayed graft function (DGF), acute rejection (AR), and length of stay (LOS) between 234 older (age ≥60 years) and 1172 younger (age 18-59 years) recipients. To investigate whether the impact of age was different for ILDKT recipients compared to 17 542 CLDKT recipients, we used an interaction term to determine whether the relationship between posttransplant outcomes and transplant type (ILDKT vs CLDKT) was modified by age. Overall, older recipients had higher mortality (hazard ratio:

Volume

23

Issue

12

First Page

1980

Last Page

1989

ISSN

1600-6143

Published In/Presented At

Long, J. J., Motter, J. D., Jackson, K. R., Chen, J., Orandi, B. J., Montgomery, R. A., Stegall, M. D., Jordan, S. C., Benedetti, E., Dunn, T. B., Ratner, L. E., Kapur, S., Pelletier, R. P., Roberts, J. P., Melcher, M. L., Singh, P., Sudan, D. L., Posner, M. P., El-Amm, J. M., Shapiro, R., … Garonzik-Wang, J. M. (2023). Characterizing the risk of human leukocyte antigen-incompatible living donor kidney transplantation in older recipients. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 23(12), 1980–1989. https://doi.org/10.1016/j.ajt.2023.09.010

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

37748554

Department(s)

Administration and Leadership

Document Type

Article