Smits Jacqueline M A, Persijn Guido G, van Houwelingen Hans C, Claas Frans H J, Frei Ulrich
Eurotransplant International Foundation, Leiden, The Netherlands.
Am J Transplant. 2002 Aug;2(7):664-70. doi: 10.1034/j.1600-6143.2002.20713.x.
On 4 January 1999, the Eurotransplant Senior Program (ESP) was implemented within the Eurotransplant kidney allocation scheme.
Kidneys obtained from donors aged over 65 years of age (65+) were allocated to a selected group of nonimmunized 65+ patients undergoing their first transplant. All transplants were performed locally to minimize cold-ischemic time. All transplants performed with kidneys from elderly donors that were allocated via ESP (ESP group) were compared to transplants performed with similar kidneys allocated via the standard renal allocation system (control group). Initial kidney function and 1-year graft outcome were assessed.
In 1999, 227 ESP and 102 control transplants were performed. The duration of cold-ischemic time was 12 and 19 h for the ESP and control groups, respectively. No rejection episodes occurred in 60% and 67% of the ESP patients and controls, respectively, while a direct kidney function was observed in 59% of ESP and 49% of control patients. The 1-year graft survival rates, censoring for graft losses due to deaths in patients with functioning grafts, were 86% and 79%, respectively.
An old-for-old renal allocation algorithm can be successful provided that risk factors, such as cold-ischemic time, are reduced.
1999年1月4日，欧洲移植高级计划（ESP）在欧洲移植肾脏分配方案中实施。
从65岁以上（65+）供体获取的肾脏分配给一组选定的首次接受移植的未免疫65+患者。所有移植均在当地进行，以尽量减少冷缺血时间。将通过ESP分配的老年供体肾脏进行的所有移植（ESP组）与通过标准肾脏分配系统分配的类似肾脏进行的移植（对照组）进行比较。评估初始肾功能和1年移植结果。
1999年，进行了227例ESP移植和102例对照移植。ESP组和对照组的冷缺血时间分别为12小时和19小时。ESP组和对照组分别有60%和67%的患者未发生排斥反应，而ESP组59%的患者和对照组49%的患者观察到直接肾功能。在因移植肾功能正常的患者死亡导致的移植丢失进行审查后，1年移植存活率分别为86%和79%。
只要减少冷缺血时间等危险因素，老年对老年的肾脏分配算法可能会成功。
