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Eurotransplant Senior Program Helps Reduce Waiting Time for Elderly Patients: Presented at ERA-EDTA

By Danny Kucharsky

COPENHAGEN, DENMARK -- July 17, 2002 -- An old-for-old renal allocation scheme can be successful provided that risk factors such as cold-ischaemic time are reduced, according to the two-year results of the Eurotransplant Senior Program's old-for-old renal allocation system.

Results of the study were unveiled here July 16 at the XXXIX Congress of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) by Dr. Jacqueline Smits, of the Research Department of Eurotransplant International, in Leiden, the Netherlands.

The Eurotransplant Senior Program (ESP) was implemented in January 1999. The programme obtained kidneys from donors older than 65 years and allocated them to a selected group of patients in the same age group who were non-immunized and were receiving their first transplant. The aims of the ESP were to achieve a more efficient use of kidneys from elderly donors and to reduce the time that elderly patients are required to wait for a kidney transplant.

The immediate function and one-year graft outcome in kidneys allocated via the ESP were compared to the control group, consisting of transplants performed with old donor kidneys allocated via the standard renal allocation system.

In the first two years, 468 ESP and 196 control transplants were performed. Waiting times were about half as long for the ESP group as they were for controls. The duration of cold ischaemia time was also shorter for the ESP group.

Nineteen percent of the control patients had a 0-1 human leukocyte antigen (HLA) mismatch compared to none in the ESP group.

About the same number of patients in each group had no rejection episodes and average serum creatinine levels at one year were also similar in both groups.

One-year graft survival rates, both including and excluding graft losses due to deaths with a functioning kidney, were similar in the two groups.

The researchers concluded that the ESP scheme can be effective in using kidneys from elderly donors and shortens the waiting time for elderly patients requiring kidney transplantation.

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