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Bjerre A, Mjøen G, Line PD, Naper C, Reisaeter AV, Åsberg A. Five decades with grandparent donors: The Norwegian strategy and experience. Pediatr Transplant 2020; 24:e13751. [PMID: 32485019 DOI: 10.1111/petr.13751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/17/2020] [Accepted: 05/06/2020] [Indexed: 11/29/2022]
Abstract
Living donors (LDs) are preferred over DDs for renal transplantation in children due to superior GS. Oslo University Hospital has never restricted living donation by upper age. The aim of this study was to investigate long-term outcomes using grandparents (GPLD) compared to PLD. Retrospective nationwide review in the period 1970-2017. First renal graft recipients using a GPLD were compared to PLD kidney recipients for long-term renal function and GS. 278 children (≤18 years) received a first renal transplant: 27/251 recipients with a GPLD/PLD. GPLD (median 59 (42-74) years) were significantly older than PLD (median 41 (23-65) years, (P < .001). Median DRAD was 52 (38-70) vs 28 (17-48) years, respectively. GS from GPLD and PLD had a 1-, 5-, and 10-year survival of 100%, 100%, and 90% vs 93%, 82%, and 72%, respectively (P = .6). In a multivariate Cox regression analysis adjusted for gender, donor age, recipient age, and year of transplant, this finding was similar (HR 0.98; 95% CI 0.34-2.84, P = .97). Five-year eGFR was 47.3 and 59.5 mL/min/1.73 m2 in the GPLD and PLD groups (P = .028), respectively. In this nationwide retrospective analysis, GS for pediatric renal recipients using GPLD was comparable to PLD. Renal function assessed as eGFR was lower in the GPLD group. The GPLD group was significantly older than the PLD group, but overall this did not impact transplant outcome. Based on these findings, older age alone should not exclude grandparent donations.
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Affiliation(s)
- Anna Bjerre
- Department of Pediatrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,University of Oslo, Oslo, Norway
| | - Geir Mjøen
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Pål-Dag Line
- University of Oslo, Oslo, Norway.,Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Christian Naper
- Department of Immunology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Anna Varberg Reisaeter
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Norwegian Renal Registry, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Anders Åsberg
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Norwegian Renal Registry, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Department of Pharmacy, University of Oslo, Oslo, Norway
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Mjøen G, Holdaas H. Impact of Living Kidney Donation on Long-Term Renal and Patient Survival: An Evolving Paradigm. CURRENT TRANSPLANTATION REPORTS 2014. [DOI: 10.1007/s40472-014-0038-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Weng FL, Reese PP, Waterman AD, Soto AG, Demissie K, Mulgaonkar S. Health care follow-up by live kidney donors more than three yr post-nephrectomy. Clin Transplant 2012; 26:E300-6. [PMID: 22686954 DOI: 10.1111/j.1399-0012.2012.01660.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Live kidney donors are advised to follow up regularly with healthcare providers to monitor kidney function and to diagnose and treat relevant comorbidities. We sought to determine the frequency and correlates of follow-up care among live kidney donors. METHODS We sent a mailed questionnaire to 606 live kidney donors from a single center who were at least three yr post-nephrectomy. RESULTS We received usable responses from 276 (45.5%), at a median of 6.2 yr post-donation. Compared with non-responders, responding donors were more likely to be older (p < 0.001), female (p = 0.002), white (p < 0.001), and married to the recipient (p < 0.001). In the prior year, 87.7% of respondents reported seeing a physician or other healthcare professional, and 79.0% had seen a "general doctor" such as their primary care provider. In univariable analyses of live kidney donors who responded to our survey, lack of medical follow-up in the past year was associated with younger age, current lack of health insurance, and infrequent contact with the transplant recipient. CONCLUSIONS Most responding live kidney donors had seen a healthcare provider within the past year. To improve donors' follow-up, transplant centers can consider targeting donors who are younger or lack health insurance.
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Affiliation(s)
- Francis L Weng
- Renal and Pancreas Transplant Division and Division of Nephrology, Department of Medicine, Saint Barnabas Medical Center, Livingston, NJ 07039, USA.
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