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Five decades with grandparent donors: The Norwegian strategy and experience
Author(s) -
Bjerre Anna,
Mjøen Geir,
Line PålDag,
Naper Christian,
Reisæter Anna Varberg,
Åsberg Anders
Publication year - 2020
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13751
Subject(s) - medicine , transplantation , retrospective cohort study , norwegian , renal function , proportional hazards model , multivariate analysis , donation , renal transplant , pediatrics , urology , philosophy , linguistics , economics , economic growth
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 m 2 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.