Interaction between donor and recipient age in determining the risk of chronic renal allograft failure

Herwig Ulf Meier-Kriesche, Diane M. Cibrik, Akinlolu O. Ojo, Julie A. Hanson, John C. Magee, Steven M. Rudich, Allan B. Leichtman, Bruce Kaplan

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

OBJECTIVES: Donor age is a known risk factor for chronic allograft failure (CAF) in renal transplant recipients. We have recently shown that advanced recipient age is also a risk factor for CAF. To investigate the interaction between donor and recipient age, we analyzed 40,289 primary solitary Caucasian adult renal transplants registered at the United States Renal Data System (USRDS) from 1988 to 1997. DESIGN: CAF was defined as allograft loss beyond 6 months posttransplantation, censored for death, recurrent disease, acute rejection, thrombosis, noncompliance, infection, or technical problems. Cox proportional hazards models were used to investigate the risk of allograft loss secondary to CAF. All models were corrected for 15 covariates including donor and recipient demographics, ischemic time, and human leukocyte antigen match. Donor and recipient age were categorized, and relative risk for allograft loss of the interaction between the obtained categorical covariates was evaluated. SETTING: Retrospective data analysis using the USRDS. PARTICIPANTS: All primary Caucasian renal transplant recipients from 1988 to 1997. RESULTS: Patients aged 55 and older who received donor kidneys had a 110% increased risk of CAF (relative risk (RR) = 2.1, 95% confidence interval (CI) = 1.9-2.3, P <.001) and recipients aged 65 and older had a 90% increased risk for CAF (RR = 1.9, 95% CI = 1.61-2.1, P <.001), compared with the youngest reference groups. In addition, there was an additive and, in the long term, synergistic interaction between donor and recipient age in determining allograft loss. CONCLUSIONS: Donor and recipient age had an independent, equivalently detrimental effect on renal allograft survival. An overall additive and, in the long term (beyond 36 months posttransplant), synergistic deleterious effect on renal allograft survival was observed for the interaction of donor and recipient age.

Original languageEnglish (US)
Pages (from-to)14-17
Number of pages4
JournalJournal of the American Geriatrics Society
Volume50
Issue number1
DOIs
StatePublished - 2002
Externally publishedYes

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Chronic Kidney Failure
Allografts
Tissue Donors
Kidney
Information Systems
Confidence Intervals
Acute Disease
HLA Antigens
Proportional Hazards Models
Renal Insufficiency
Thrombosis
Demography
Transplants

Keywords

  • Age
  • Nephropathy
  • Renal
  • Transplant

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Meier-Kriesche, H. U., Cibrik, D. M., Ojo, A. O., Hanson, J. A., Magee, J. C., Rudich, S. M., ... Kaplan, B. (2002). Interaction between donor and recipient age in determining the risk of chronic renal allograft failure. Journal of the American Geriatrics Society, 50(1), 14-17. https://doi.org/10.1046/j.1532-5415.2002.50002.x

Interaction between donor and recipient age in determining the risk of chronic renal allograft failure. / Meier-Kriesche, Herwig Ulf; Cibrik, Diane M.; Ojo, Akinlolu O.; Hanson, Julie A.; Magee, John C.; Rudich, Steven M.; Leichtman, Allan B.; Kaplan, Bruce.

In: Journal of the American Geriatrics Society, Vol. 50, No. 1, 2002, p. 14-17.

Research output: Contribution to journalArticle

Meier-Kriesche, HU, Cibrik, DM, Ojo, AO, Hanson, JA, Magee, JC, Rudich, SM, Leichtman, AB & Kaplan, B 2002, 'Interaction between donor and recipient age in determining the risk of chronic renal allograft failure', Journal of the American Geriatrics Society, vol. 50, no. 1, pp. 14-17. https://doi.org/10.1046/j.1532-5415.2002.50002.x
Meier-Kriesche, Herwig Ulf ; Cibrik, Diane M. ; Ojo, Akinlolu O. ; Hanson, Julie A. ; Magee, John C. ; Rudich, Steven M. ; Leichtman, Allan B. ; Kaplan, Bruce. / Interaction between donor and recipient age in determining the risk of chronic renal allograft failure. In: Journal of the American Geriatrics Society. 2002 ; Vol. 50, No. 1. pp. 14-17.
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abstract = "OBJECTIVES: Donor age is a known risk factor for chronic allograft failure (CAF) in renal transplant recipients. We have recently shown that advanced recipient age is also a risk factor for CAF. To investigate the interaction between donor and recipient age, we analyzed 40,289 primary solitary Caucasian adult renal transplants registered at the United States Renal Data System (USRDS) from 1988 to 1997. DESIGN: CAF was defined as allograft loss beyond 6 months posttransplantation, censored for death, recurrent disease, acute rejection, thrombosis, noncompliance, infection, or technical problems. Cox proportional hazards models were used to investigate the risk of allograft loss secondary to CAF. All models were corrected for 15 covariates including donor and recipient demographics, ischemic time, and human leukocyte antigen match. Donor and recipient age were categorized, and relative risk for allograft loss of the interaction between the obtained categorical covariates was evaluated. SETTING: Retrospective data analysis using the USRDS. PARTICIPANTS: All primary Caucasian renal transplant recipients from 1988 to 1997. RESULTS: Patients aged 55 and older who received donor kidneys had a 110{\%} increased risk of CAF (relative risk (RR) = 2.1, 95{\%} confidence interval (CI) = 1.9-2.3, P <.001) and recipients aged 65 and older had a 90{\%} increased risk for CAF (RR = 1.9, 95{\%} CI = 1.61-2.1, P <.001), compared with the youngest reference groups. In addition, there was an additive and, in the long term, synergistic interaction between donor and recipient age in determining allograft loss. CONCLUSIONS: Donor and recipient age had an independent, equivalently detrimental effect on renal allograft survival. An overall additive and, in the long term (beyond 36 months posttransplant), synergistic deleterious effect on renal allograft survival was observed for the interaction of donor and recipient age.",
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T1 - Interaction between donor and recipient age in determining the risk of chronic renal allograft failure

AU - Meier-Kriesche, Herwig Ulf

AU - Cibrik, Diane M.

AU - Ojo, Akinlolu O.

AU - Hanson, Julie A.

AU - Magee, John C.

AU - Rudich, Steven M.

AU - Leichtman, Allan B.

AU - Kaplan, Bruce

PY - 2002

Y1 - 2002

N2 - OBJECTIVES: Donor age is a known risk factor for chronic allograft failure (CAF) in renal transplant recipients. We have recently shown that advanced recipient age is also a risk factor for CAF. To investigate the interaction between donor and recipient age, we analyzed 40,289 primary solitary Caucasian adult renal transplants registered at the United States Renal Data System (USRDS) from 1988 to 1997. DESIGN: CAF was defined as allograft loss beyond 6 months posttransplantation, censored for death, recurrent disease, acute rejection, thrombosis, noncompliance, infection, or technical problems. Cox proportional hazards models were used to investigate the risk of allograft loss secondary to CAF. All models were corrected for 15 covariates including donor and recipient demographics, ischemic time, and human leukocyte antigen match. Donor and recipient age were categorized, and relative risk for allograft loss of the interaction between the obtained categorical covariates was evaluated. SETTING: Retrospective data analysis using the USRDS. PARTICIPANTS: All primary Caucasian renal transplant recipients from 1988 to 1997. RESULTS: Patients aged 55 and older who received donor kidneys had a 110% increased risk of CAF (relative risk (RR) = 2.1, 95% confidence interval (CI) = 1.9-2.3, P <.001) and recipients aged 65 and older had a 90% increased risk for CAF (RR = 1.9, 95% CI = 1.61-2.1, P <.001), compared with the youngest reference groups. In addition, there was an additive and, in the long term, synergistic interaction between donor and recipient age in determining allograft loss. CONCLUSIONS: Donor and recipient age had an independent, equivalently detrimental effect on renal allograft survival. An overall additive and, in the long term (beyond 36 months posttransplant), synergistic deleterious effect on renal allograft survival was observed for the interaction of donor and recipient age.

AB - OBJECTIVES: Donor age is a known risk factor for chronic allograft failure (CAF) in renal transplant recipients. We have recently shown that advanced recipient age is also a risk factor for CAF. To investigate the interaction between donor and recipient age, we analyzed 40,289 primary solitary Caucasian adult renal transplants registered at the United States Renal Data System (USRDS) from 1988 to 1997. DESIGN: CAF was defined as allograft loss beyond 6 months posttransplantation, censored for death, recurrent disease, acute rejection, thrombosis, noncompliance, infection, or technical problems. Cox proportional hazards models were used to investigate the risk of allograft loss secondary to CAF. All models were corrected for 15 covariates including donor and recipient demographics, ischemic time, and human leukocyte antigen match. Donor and recipient age were categorized, and relative risk for allograft loss of the interaction between the obtained categorical covariates was evaluated. SETTING: Retrospective data analysis using the USRDS. PARTICIPANTS: All primary Caucasian renal transplant recipients from 1988 to 1997. RESULTS: Patients aged 55 and older who received donor kidneys had a 110% increased risk of CAF (relative risk (RR) = 2.1, 95% confidence interval (CI) = 1.9-2.3, P <.001) and recipients aged 65 and older had a 90% increased risk for CAF (RR = 1.9, 95% CI = 1.61-2.1, P <.001), compared with the youngest reference groups. In addition, there was an additive and, in the long term, synergistic interaction between donor and recipient age in determining allograft loss. CONCLUSIONS: Donor and recipient age had an independent, equivalently detrimental effect on renal allograft survival. An overall additive and, in the long term (beyond 36 months posttransplant), synergistic deleterious effect on renal allograft survival was observed for the interaction of donor and recipient age.

KW - Age

KW - Nephropathy

KW - Renal

KW - Transplant

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