ReviewTransplantation2017
Strategies for an Expanded Use of Kidneys From Elderly Donors.
Review in Transplantation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed.
- Impact of older donor age in kidney transplants in a biopsy-based observational study.JCI insight · 2026Observational
- Practical Guide to Address Common Myths in the Pre- and Post-kidney Transplant Management of the Elderly Patient with Cancer: An Opinion Paper.Transplantation direct · 2026Article
- Measurement Matters: A Metrological Approach to Renal Preimplantation Biopsy Evaluation to Address Uncertainty in Organ Selection.Transplantation direct · 2024Article
- Kidney transplants from elderly donors: what we have learned 20 years after the Crystal City consensus criteria meeting.Journal of nephrology · 2024Review
- A Machine Learning-Driven Virtual Biopsy System For Kidney Transplant Patients.Nature communications · 2024Article
- Current Evidence and Future Perspectives to Implement Continuous and End-Ischemic Use of Normothermic and Oxygenated Hypothermic Machine Perfusion in Clinical Practice.Journal of clinical medicine · 2023Review
- Protection From Second Warm Ischemic Injury Using a Thermal Barrier Bag in Kidney Transplantation.Transplantation direct · 2023Article
- Performance of Scores Predicting Adverse Outcomes in Procurement Kidney Biopsies From Deceased Donors With Organs of Lower-Than-Average Quality.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- Vigilance Data in Organ Donation and Solid Organ Transplantation in Germany: Six Years of Experience 2016-2022.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- The New Age of Organ Donation-What Factors Have an Influence on the Attitude of Older People? An Attitudinal Survey in Southeastern Spain.International journal of environmental research and public health · 2022Article
- Explant of one graft due to technical complications in dual kidney transplants: analysis of the long-term function of the remaining kidney.Journal of nephrology · 2021Article
- Long-Term Results of Kidney Transplantation in the Elderly: Comparison between Different Donor Settings.Journal of clinical medicine · 2021Article
- Simply Adding Oxygen during Hypothermic Machine Perfusion to Combat the Negative Effects of Ischemia-Reperfusion Injury: Fundamentals and Current Evidence for Kidneys.Biomedicines · 2021Review
- US deceased kidney transplantation: Estimated GFR, donor age and KDPI association with graft survival.EClinicalMedicine · 2021Article
- Kidney transplantation outcomes from elderly donors after circulatory death: a comparison with elderly brain-dead donors.Clinical kidney journal · 2021Article
- Prognostic value for long-term graft survival of estimated glomerular filtration rate and proteinuria quantified at 3 months after kidney transplantation.Clinical kidney journal · 2020Article
- Prediction scores for risk of allograft loss in patients receiving kidney transplants: nil satis nisi optimum.Clinical kidney journal · 2020Article
- Treatment options for localised renal cell carcinoma of the transplanted kidney.World journal of transplantation · 2020Review
- Utility and safety of early allograft biopsy in adult deceased donor kidney transplant recipients.Clinical and experimental nephrology · 2020Article
- Impact of acute kidney injury in elderly versus young deceased donors on post-transplant outcomes: A multicenter cohort study.Scientific reports · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The old-for-old allocation policy used for kidney transplantation (KT) has confirmed the survival benefit compared to remaining listed on dialysis. Shortage of standard donors has stimulated the development of strategies aimed to expand acceptance criteria, particularly of kidneys from elderly donors. We have systematically reviewed the literature on those different strategies. In addition to the review of outcomes of expanded criteria donor or advanced age kidneys, we assessed the value of the Kidney Donor Profile Index policy, preimplantation biopsy, dual KT, machine perfusion and special immunosuppressive protocols. Survival and functional outcomes achieved with expanded criteria donor, high Kidney Donor Profile Index or advanced age kidneys are poorer than those with standard ones. Outcomes using advanced age brain-dead or cardiac-dead donor kidneys are similar. Preimplantation biopsies and related scores have been useful to predict function, but their applicability to transplant or refuse a kidney graft has probably been overestimated. Machine perfusion techniques have decreased delayed graft function and could improve graft survival. Investing 2 kidneys in 1 recipient does not make sense when a single KT would be enough, particularly in elderly recipients. Tailored immunosuppression when transplanting an old kidney may be useful, but no formal trials are available.Old donors constitute an enormous source of useful kidneys, but their retrieval in many countries is infrequent. The assumption of limited but precious functional expectancy for an old kidney and substantial reduction of discard rates should be generalized to mitigate these limitations.
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