Kidneys from deceased donors: Maximizing the value of a scarce resource

Herwig Ulf Meier-Kriesche, Jesse D. Schold, Robert S. Gaston, Jonas Wadstrom, Bruce Kaplan

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Donor age is a significant risk factor for graft loss after kidney transplantation. We investigated the question whether significant graft years were being lost through transplantation of younger donor kidneys into older recipients with potentially shorter lifespans than the organs they receive. We examined patient and graft survival for deceased donor kidney transplants performed in the United States between the years 1990 and 2002 by Kaplan-Meier plots. We categorized the distribution of deceased donor kidneys by donor and recipient age. Subsequently, we calculated the actual and projected graft survival of transplanted kidneys from younger donors with the patient survival of transplant recipients of varying ages. Over the study period, 16.4% (9250) transplants from donors aged 15-50 were transplanted to recipients over the age of 60. At the same time, 73.6% of donors above the age of 50 were allocated to recipients under the age of 60. The graft survival of grafts from younger donors significantly exceeded the patient survival of recipients over the age of 60. The overall projected improvement in graft survival, by excluding transplantation of younger kidneys to older recipients, was approximately 3 years per transplant. Avoiding the allocation of young donor kidneys to elderly recipients, could have significantly increased the overall graft life, by a total 27 500 graft years, between 1990 and 2002, with projected cost savings of about 1.5 billion dollars.

Original languageEnglish (US)
Pages (from-to)1725-1730
Number of pages6
JournalAmerican Journal of Transplantation
Volume5
Issue number7
DOIs
StatePublished - Jul 2005
Externally publishedYes

Fingerprint

Tissue Donors
Kidney
Transplants
Graft Survival
Kidney Transplantation
Survival
Cost Savings
Transplantation

Keywords

  • Age
  • Allocation
  • Deceased donor
  • Graft survival
  • Kidney transplantation
  • Waiting list

ASJC Scopus subject areas

  • Immunology

Cite this

Meier-Kriesche, H. U., Schold, J. D., Gaston, R. S., Wadstrom, J., & Kaplan, B. (2005). Kidneys from deceased donors: Maximizing the value of a scarce resource. American Journal of Transplantation, 5(7), 1725-1730. https://doi.org/10.1111/j.1600-6143.2005.00923.x

Kidneys from deceased donors : Maximizing the value of a scarce resource. / Meier-Kriesche, Herwig Ulf; Schold, Jesse D.; Gaston, Robert S.; Wadstrom, Jonas; Kaplan, Bruce.

In: American Journal of Transplantation, Vol. 5, No. 7, 07.2005, p. 1725-1730.

Research output: Contribution to journalArticle

Meier-Kriesche, HU, Schold, JD, Gaston, RS, Wadstrom, J & Kaplan, B 2005, 'Kidneys from deceased donors: Maximizing the value of a scarce resource', American Journal of Transplantation, vol. 5, no. 7, pp. 1725-1730. https://doi.org/10.1111/j.1600-6143.2005.00923.x
Meier-Kriesche, Herwig Ulf ; Schold, Jesse D. ; Gaston, Robert S. ; Wadstrom, Jonas ; Kaplan, Bruce. / Kidneys from deceased donors : Maximizing the value of a scarce resource. In: American Journal of Transplantation. 2005 ; Vol. 5, No. 7. pp. 1725-1730.
@article{d1daecc1e24b472ca85527a03af8f0a0,
title = "Kidneys from deceased donors: Maximizing the value of a scarce resource",
abstract = "Donor age is a significant risk factor for graft loss after kidney transplantation. We investigated the question whether significant graft years were being lost through transplantation of younger donor kidneys into older recipients with potentially shorter lifespans than the organs they receive. We examined patient and graft survival for deceased donor kidney transplants performed in the United States between the years 1990 and 2002 by Kaplan-Meier plots. We categorized the distribution of deceased donor kidneys by donor and recipient age. Subsequently, we calculated the actual and projected graft survival of transplanted kidneys from younger donors with the patient survival of transplant recipients of varying ages. Over the study period, 16.4{\%} (9250) transplants from donors aged 15-50 were transplanted to recipients over the age of 60. At the same time, 73.6{\%} of donors above the age of 50 were allocated to recipients under the age of 60. The graft survival of grafts from younger donors significantly exceeded the patient survival of recipients over the age of 60. The overall projected improvement in graft survival, by excluding transplantation of younger kidneys to older recipients, was approximately 3 years per transplant. Avoiding the allocation of young donor kidneys to elderly recipients, could have significantly increased the overall graft life, by a total 27 500 graft years, between 1990 and 2002, with projected cost savings of about 1.5 billion dollars.",
keywords = "Age, Allocation, Deceased donor, Graft survival, Kidney transplantation, Waiting list",
author = "Meier-Kriesche, {Herwig Ulf} and Schold, {Jesse D.} and Gaston, {Robert S.} and Jonas Wadstrom and Bruce Kaplan",
year = "2005",
month = "7",
doi = "10.1111/j.1600-6143.2005.00923.x",
language = "English (US)",
volume = "5",
pages = "1725--1730",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Kidneys from deceased donors

T2 - Maximizing the value of a scarce resource

AU - Meier-Kriesche, Herwig Ulf

AU - Schold, Jesse D.

AU - Gaston, Robert S.

AU - Wadstrom, Jonas

AU - Kaplan, Bruce

PY - 2005/7

Y1 - 2005/7

N2 - Donor age is a significant risk factor for graft loss after kidney transplantation. We investigated the question whether significant graft years were being lost through transplantation of younger donor kidneys into older recipients with potentially shorter lifespans than the organs they receive. We examined patient and graft survival for deceased donor kidney transplants performed in the United States between the years 1990 and 2002 by Kaplan-Meier plots. We categorized the distribution of deceased donor kidneys by donor and recipient age. Subsequently, we calculated the actual and projected graft survival of transplanted kidneys from younger donors with the patient survival of transplant recipients of varying ages. Over the study period, 16.4% (9250) transplants from donors aged 15-50 were transplanted to recipients over the age of 60. At the same time, 73.6% of donors above the age of 50 were allocated to recipients under the age of 60. The graft survival of grafts from younger donors significantly exceeded the patient survival of recipients over the age of 60. The overall projected improvement in graft survival, by excluding transplantation of younger kidneys to older recipients, was approximately 3 years per transplant. Avoiding the allocation of young donor kidneys to elderly recipients, could have significantly increased the overall graft life, by a total 27 500 graft years, between 1990 and 2002, with projected cost savings of about 1.5 billion dollars.

AB - Donor age is a significant risk factor for graft loss after kidney transplantation. We investigated the question whether significant graft years were being lost through transplantation of younger donor kidneys into older recipients with potentially shorter lifespans than the organs they receive. We examined patient and graft survival for deceased donor kidney transplants performed in the United States between the years 1990 and 2002 by Kaplan-Meier plots. We categorized the distribution of deceased donor kidneys by donor and recipient age. Subsequently, we calculated the actual and projected graft survival of transplanted kidneys from younger donors with the patient survival of transplant recipients of varying ages. Over the study period, 16.4% (9250) transplants from donors aged 15-50 were transplanted to recipients over the age of 60. At the same time, 73.6% of donors above the age of 50 were allocated to recipients under the age of 60. The graft survival of grafts from younger donors significantly exceeded the patient survival of recipients over the age of 60. The overall projected improvement in graft survival, by excluding transplantation of younger kidneys to older recipients, was approximately 3 years per transplant. Avoiding the allocation of young donor kidneys to elderly recipients, could have significantly increased the overall graft life, by a total 27 500 graft years, between 1990 and 2002, with projected cost savings of about 1.5 billion dollars.

KW - Age

KW - Allocation

KW - Deceased donor

KW - Graft survival

KW - Kidney transplantation

KW - Waiting list

UR - http://www.scopus.com/inward/record.url?scp=21344447313&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=21344447313&partnerID=8YFLogxK

U2 - 10.1111/j.1600-6143.2005.00923.x

DO - 10.1111/j.1600-6143.2005.00923.x

M3 - Article

C2 - 15943632

AN - SCOPUS:21344447313

VL - 5

SP - 1725

EP - 1730

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 7

ER -