@article{5a04205d258d4a3ca0ece1feeb630b19,
title = "Interactions Between Donor Age and 12-Month Estimated Glomerular Filtration Rate on Allograft and Patient Outcomes After Kidney Transplantation",
abstract = "Reduced estimated glomerular filtration rate (eGFR) at 12-months after kidney transplantation is associated with increased risk of allograft loss, but it is uncertain whether donor age and types modify this relationship. Using Australia and New Zealand registry data, multivariable Cox proportional modelling was used to examine the interactive effects between donor age, types and 12-month eGFR on overall allograft loss. We included 11,095 recipients (4,423 received live-donors). Recipients with lowest 12-month eGFR (<30 ml/min/1.73 m2) experienced the greatest risk of allograft loss, with adjusted HR [95% CI) of 2.65 [2.38–2.95] compared to eGFR of 30–60 ml/min/1.73 m2; whereas the adjusted HR for highest eGFR (>60 ml/min/1.73 m2) was 0.67 [0.62–0.74]. The association of 12-month eGFR and allograft loss was modified by donor age (but not donor types) where a higher risk of allograft loss in recipients with lower compared with higher 12-month eGFR being most pronounced in the younger donor age groups (p < 0.01). Recipients with eGFR <30 ml/min/1.73 m2 12-months after transplantation experienced ≥2.5-fold increased risk of overall allograft loss compared to those with eGFR of >60 ml/min/1.73 m2, and the magnitude of the increased risk is most marked among recipients with younger donors. Careful deliberation of other factors including donor age when considering eGFR as a surrogate for clinical endpoints is warranted.",
keywords = "allograft failure, donor age, donor type, estimated glomerular filtration rate, kidney transplantation, patient and graft survival, registry",
author = "Lim, {Wai H.} and Esther Ooi and Pilmore, {Helen L.} and Johnson, {David W.} and McDonald, {Stephen P.} and Philip Clayton and Carmel Hawley and Mulley, {William R.} and Ross Francis and Collins, {Michael G.} and Bryon Jaques and Larkins, {Nicholas G.} and Davies, {Christopher E.} and Kate Wyburn and Chadban, {Steve J.} and Germaine Wong",
note = "Funding Information: The authors would like to gratefully acknowledge the substantial contributions of the entire Australian and New Zealand nephrology community (physicians, surgeons, database managers, nurses, renal operators and patients) that provide information to, and maintain, the ANZDATA database. The data reported here have been supplied by the ANZDATA registry. The interpretation and reporting of these data are the authors{\textquoteright} responsibility and in no way should be seen as official policy or interpretation of the ANZDATA registry. DJ is supported by a National Health and Medical Research Council Practitioner Fellowship. GW is supported by a National Health and Medical Research Council Career Development Fellowship. NL is supported by a Clinician Research Fellowship from the Department of Health and Raine Medical Research Foundation. EO is supported by a Heart Foundation Future Leader Fellowship (Award ID: 102538). Publisher Copyright: Copyright {\textcopyright} 2022 Lim, Ooi, Pilmore, Johnson, McDonald, Clayton, Hawley, Mulley, Francis, Collins, Jaques, Larkins, Davies, Wyburn, Chadban and Wong.",
year = "2022",
month = feb,
day = "7",
doi = "10.3389/ti.2022.10199",
language = "English",
volume = "36",
journal = "Transplant International",
issn = "0934-0874",
publisher = "John Wiley & Sons",
}