title: Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program (ESP): A Single-Center Experience from 2008 to 2013.
abstract: BACKGROUND
  The aim of this study was to evaluate the outcome after transplantation of deceased allografts in donor/recipient pairs aged ≥65 years enrolled in the Eurotransplant Senior Program (ESP).
  
  
  METHODS
  In this retrospective cohort study we evaluated data from 89 patients transplanted under the ESP protocol from 2008 to 2013. Outcome parameters included graft and patient survival, rate of biopsy-proven acute rejections (BPAR), peri- and post-operative complications, tumor development, development of donor-specific antibodies (DSA), and the prognostic role of preimplantation biopsies.
  
  
  RESULTS
  One-year patient and allograft survival rates were 92.1% and 84.3%, respectively. During follow-up, 23 (26%) patients died; the major cause of death was sepsis, followed by cardiovascular events and malignancies. BPAR episodes were frequent within the first year (~33%) and overall were less common in patients treated with tacrolimus. Post-transplant malignancies were seen in 15 (17%) patients. During follow-up, 16 (18%) patients developed DSA; patients with delayed graft function (DGF) were more likely to develop DSA (p=0.029). A higher preimplantation biopsy score was associated with DGF but did not predict later graft outcome.
  
  
  CONCLUSIONS
  The results highlight increased risks in ESP transplant candidates and the importance of careful surveillance of this patient group.
authors: Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors: Johannes
authors: J
authors: Jacobi
authors: Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors: Sophie
authors: S
authors: Beckmann
authors: Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors: Katharina
authors: K
authors: Heller
authors: Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors: Karl F
authors: KF
authors: Hilgers
authors: Department of Urology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors: Hendrik
authors: H
authors: Apel
authors: Department of Hematology and Oncology, riedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors: Bernd
authors: B
authors: Spriewald
authors: Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors: Kai-Uwe
authors: KU
authors: Eckardt
authors: Department of Nephropathology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors: Kerstin U
authors: KU
authors: Amann
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000401:mortality; D016014:Linear Models; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors; D014184:Transplantation, Homologous