Evaluation of the Eurotransplant Senior Program. The results of the first year.
On 4 January 1999, the Eurotransplant Senior Program (ESP) was implemented within the Eurotransplant kidney allocation scheme.


METHODS
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.


RESULTS
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.


CONCLUSIONS
An old-for-old renal allocation algorithm can be successful provided that risk factors, such as cold-ischemic time, are reduced.
Smits
Jacqueline M A
JM
Eurotransplant International Foundation, Leiden, The Netherlands. jsmits@eurotransplant.nl
Persijn
Guido G
GG
van Houwelingen
Hans C
HC
Claas
Frans H J
FH
Frei
Ulrich
U
D000367:Age Factors; D000368:Aged; D005060:Europe; D005260:Female; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology* / Q000706:statistics & numerical data; D008297:Male; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000592:standards / Q000706:statistics & numerical data*