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Çiçek SNK, Huseynov A, Tuncer M. Results in Kidney Transplant Recipients from Living Donors 75 Years of Age or Older. Transplant Proc 2024; 56:281-284. [PMID: 38368133 DOI: 10.1016/j.transproceed.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 12/06/2023] [Accepted: 12/28/2023] [Indexed: 02/19/2024]
Abstract
The increasing age of patients receiving renal replacement therapy (RRT) in Turkey, coupled with a shortage of kidney donors, has led to longer waiting times for transplants and an escalation in mortality rates. This retrospective study aimed to assess the effect on transplant outcomes of accepting kidneys from donors ≥70 years of age, given the rising number of older patients in the population. In all, 1400 patients were transplanted with kidneys from donors >50 years, with patient and graft survival as primary endpoints. Our results demonstrated that the most significant risk factors for graft function were recipient age >65 years, male sex, and presence of type 2 diabetes. Moreover, kidneys from donors ≥75 years of age achieved a half-life of 5 years. These findings suggest that donor age does not necessarily correlate with graft failure and that transplantation from older donors could help alleviate the organ shortage. Further research is needed to substantiate these conclusions.
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Affiliation(s)
| | - Amil Huseynov
- Beykoz University Dialysis Program, Beykoz/İstanbul, Turkey.
| | - Murat Tuncer
- Medicana Hospital Transplantation Department, Istanbul, Turkey
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Huseynov A, Baumann S, Nef H, Riemer T, Schneider S, Pfannebecker T, Achenbach S, Mehilli J, Gori T, Woehrle J, Zahn R, Schmermund A, Richard G, Hamm C, Akin I. P2809Comparison between treatment of “established” versus complex “off-label” coronary lesions with Absorb bioresorbable scaffold implantation: results from the GABI-R registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
The purpose of this study was to compare the clinical outcomes of patients treated with bioresorbable scaffold (BRS) for off-label versus approved indications.
Background
The BRS promised some advantages in terms of complete biodegradation, however, the implication of BRS for off-label indications is not well described.
Methods
The short- and long-term outcome after implantation of a bioresorbable scaffold system (ABSORB, Abbott Vascular, USA) was evaluated in the prospective, non-interventional, multicenter real-world German-Austrian ABSORB RegIstRy (GABI-R).
Results
A total of 3,188 patients were enrolled. Patients were divided into two groups: on-label BRS use (33.0%) and off-label use (66.9%) if at least one off-label use criteria was met. The incidence of scaffold thrombosis in confirmed cases was significantly higher in off-label group (1.36% vs. 0.57%, p=0.04; OR 2.41 (95% CI: 1.00–5.82) with also a trend towards higher myocardial infarction rate (2.39% vs. 1.42%, p=0.077; OR 1.70 (95% CI: 0.95–3.03) and cardiovascular death (1.27% vs. 1.14%, p=0.76, OR 1.11 (95% CI: 0.56–2.21) at 6 months follow up.
Clinical outcome at 6 months Total Off-label On-label p-value* OR (95%-CI) Patients with 6m FU record 99.0% 99.0% 99.1% 0.82 0.92 (0.43–1.95) Confirmed cardiovascular death 1.22% 1.27% 1.14% 0.76 1.11 (0.56–2.21) Confirmed non-cardiovascular death 0.22% 0.14% 0.38% 0.18 0.37 (0.08–1.66) Cause unknown 0.22% 0.28% 0.09% 0.29 2.97 (0.36–24.73) Hospitalisation 27.5% 27.9% 26.7% 0.51 1.06 (0.89–1.27) MI 2.07% 2.39% 1.42% 0.07 1.70 (0.95–3.03) ARC definite scaffold thrombosis 1.10% 1.36% 0.57% 0.04 2.41 (1.00–5.82) TLF 2.70% 3.00% 2.09% 0.13 1.45 (0.89–2.37) TVF 3.98% 4.31% 3.32% 0.18 1.31 (0.88–1.95) MACE 4.33% 4.64% 3.70% 0.22 1.27 (0.87–1.85) Values are mean ± standard deviation (SD) or number and percentage (n, %). *Comparison between off-label and on-label use. The p-values are from Chi-squared test or Mann-Whitney-Wilcoxon test. ARC, academic research consortium; FU, follow up; MACE, major adverse cardiac events; PCI, percutaneous coronary intervention; TLF, target lesion failure; TVF, target vessel failure.
Kaplan-Meyer curve stent thrombosis
Conclusions
The off-label use of BRS compared to confirmed indications appears to be associated with a higher rate of clinical endpoints considering more complex lesions and higher morbidity in this patients' group.
Acknowledgement/Funding
This research was supported by a grant from Abbott Vascular.
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Affiliation(s)
- A Huseynov
- University Medical Centre of Mannheim, Mannheim, Germany
| | - S Baumann
- University Medical Centre of Mannheim, Mannheim, Germany
| | - H Nef
- University Hospital Giessen and Marburg, Giessen, Germany
| | - T Riemer
- Heart Attack Research Center, Ludwigshafen am Rhein, Germany
| | - S Schneider
- Heart Attack Research Center, Ludwigshafen am Rhein, Germany
| | | | - S Achenbach
- University of Erlangen-Nuremberg, Erlangen, Germany
| | - J Mehilli
- Central Hospital Bad Berka, Bad Berka, Germany
| | - T Gori
- University Medical Center of Mainz, Mainz, Germany
| | | | - R Zahn
- Klinikum Ludwigshafen, Ludwigshafen am Rhein, Germany
| | - A Schmermund
- CardioVascular Center Bethanien (CCB), Frankfurt am Main, Germany
| | - G Richard
- Heart Center Bad Segeberg, Bad Segeberg, Germany
| | - C Hamm
- University Hospital Giessen and Marburg, Giessen, Germany
| | - I Akin
- University Medical Centre of Mannheim, Mannheim, Germany
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Baumann S, Frambach D, Huseynov A, Becher T, Boecker C, Behnes M, Rapp S, Papavassiliu T, Borggrefe M, Akin I. The value of multimodality imaging for detection, characterisation and management of a wall adhering structure in the right atrium. Images Paediatr Cardiol 2014; 16:1-7. [PMID: 26236367 PMCID: PMC4521328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The case presents a wall adherent structure in the right atrium in a young patient with peripheral t-cell lymphoma followed by successful prolonged lysis therapy resulting in the resolution of the thrombus is presented. This case highlights the utility of multimodality imaging in an accurate assessment of the right atrium thrombus and the effectiveness of prolonged lysis therapy.
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Affiliation(s)
- S Baumann
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.,Stefan Baumann: First Department of Medicine, Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM), University of Heidelberg, Theodor-Kutzer-Ufer 1-3 68167 Mannheim, Germany. +49 621 383 2381
| | - D Frambach
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - A Huseynov
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - T Becher
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - C Boecker
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - M Behnes
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - S Rapp
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - T Papavassiliu
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - M Borggrefe
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
| | - I Akin
- First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany
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