Improved Utilization Rate in Solid Organ Donors ≥80 Years: The 7-Year Tuscany Experience

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-03-27 DOI:10.1111/ctr.70142

Chiara Lazzeri, Davide Ghinolfi, Lara Entani Santini, Arianna Precisi o Procissi, Daniele Cultrera, Adriano Peris

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引用次数: 0

Abstract

Introduction

The Tuscany Region has a quite high annual number of donors per million population (100 donors/pmp (annually)). Considering the increasing donor age and organ shortage, the donation and transplantation community needs to expand procurement and transplants from elderly donors. We assessed the utilization rate in donors aged ≥80 years during the study period (2018–2024) in Tuscany.

Methods

Our retrospective observational study comprised 809 donors aged ≥80 years. We compared Period 1 (from 2018 to 2020, before the COVID pandemic) to Period 2 (from 2021 to 2024, after the COVID pandemic).

Results

cDCD donors significantly increased in Period 2 (0.0001). The utilization rate increased from Period 1 to Period 2 (81.5% vs. 91.7%). In the study period (2018–2024), 377 liver transplants were performed. Overall graft and patient survival at 1, 3, and 5 years when an octogenarian graft was used was 89.4%, 85.0%, 81.8% and 92.5%, 88.7%, 85.5%, respectively. EAD (early allograft dysfunction) was observed in 2.9% of the cases, and IC (ischemic cholangiopathy) developed in 6.3% of the cases. Forty kidneys were transplanted into 22 patients, including 18 dual kidney transplants.

Conclusions

During the 7-year study period, donors aged ≥80 years represented a consistent subgroup, since they accounted for one-third of the overall donor population. The increase in utilization rate observed during the study period may be related to several factors, both in the procurement and the transplant phase.

Trial Registration: Clinicaltrial.gov: #NCT04744389

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≥80岁实体器官供体利用率的提高：托斯卡纳的7年经验

托斯卡纳地区每年每百万人口的捐助者数量相当高（100个捐助者/pmp（每年））。考虑到供体年龄的增长和器官短缺，捐赠和移植界需要扩大老年供体的采购和移植。我们评估了托斯卡纳地区在研究期间（2018-2024）年龄≥80岁的献血者的使用率。方法回顾性观察研究纳入809名年龄≥80岁的献血者。我们比较了第一阶段（2018年至2020年，在COVID大流行之前）和第二阶段（2021年至2024年，在COVID大流行之后）。结果第2期cDCD供体显著增加（0.0001）。从第一阶段到第二阶段，利用率增加了（81.5% vs. 91.7%）。在研究期间（2018-2024年），进行了377例肝移植手术。当使用80岁高龄的移植物时，1年、3年和5年的总体移植物和患者生存率分别为89.4%、85.0%、81.8%和92.5%、88.7%、85.5%。2.9%的病例发生了EAD（早期同种异体移植物功能障碍），6.3%的病例发生了IC（缺血性胆管病）。22例患者共移植肾40个，其中双肾移植18例。在为期7年的研究期间，年龄≥80岁的献血者是一个一致的亚组，因为他们占献血者总人数的三分之一。在研究期间观察到的利用率的增加可能与采收和移植阶段的几个因素有关。试验注册：Clinicaltrial.gov: #NCT04744389

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.