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Disclosure of Interest
MARIAN KLINGER

No interest conflicts to declare

The details of each Disclosure of Interest are available at the Invited Speakers desk (located
in the Registration Area).

Organ age and immune

responses

Marian Klinger
Department of Nephrology and
Transplantation Medicine
Medical University, Wrocaw, Poland

Incidence of RRT pmp at Day 1, among all national and regional renal registries in 30
countries reporting to the ERAEDTA Registry in 2011.

Marlies Noordzij et al. Clin Kidney J

2014;7:227-238

Marlies Noordzij et al. Clin Kidney J 2014;7:227-238

.

Expected remaining lifetimes of prevalent dialysis and renal transplant patients in 2010 and
2011 compared with the 2005 general population statistics.

Marlies Noordzij et al. Clin Kidney J 2014;7:227-238

.

Heinbokel et al. ,Transplant Rev (Orlando). 2013; 27(3): 6575.

Ischaemia reduces the oxygen supply to renal cells.

Claudio Ponticelli Nephrol. Dial. Transplant. 2014;29:11341140

Endothelial cells represent a privileged target for both ischaemia-reperfusion injury and
rejection.

Claudio Ponticelli Nephrol. Dial. Transplant. 2014;29:11341140

Delayed Graft Function in the Kidney Transplant

Siedlecki et al., Am J Transplant. 2011; 11(11): 22792296

Delayed Graft Function in the Kidney Transplant

Siedlecki et al., Am J Transplant. 2011; 11(11): 22792296

Donor Age-Specific Injury and Immune Responses

Oberhuber et al., American Journal of Transplantation 2012; 12: 3842

THE INFLUENCE OF BRAIN DEATH ON GENE

EXPRESSION AND KIDNEY ALLOGRAFT FUNCTION
Chudoba P. et al. Ongoing study

78 KTx from 43 donors were included in this study ( mean age

4713 years).
The biopsy was obtained during organ retrieval, 5 minutes before
cold perfusion of the kidney.
Gene expression of LCN2 ( NGAL), HAVCR1 (KIM-1),and
TGB-beta correlated significantly with donor age.

Donor age intensifies the early immune response after transplantation

A Reutzel-Selke et al., Kidney International (2007) 71, 629636

Pratschke et al., Transplantation 2009;87: 992

Prospective Age-Matching in Elderly Kidney Transplant RecipientsA 5-Year Analysis

of the Eurotransplant Senior Program

Frei et al., American Journal of Transplantation 2008; 8: 5057

Tullius et al., Annals of Surgery Volume 252, Number 4, October 2010

Tullius, Milford: N Engl J Med 364;14, 1369

Incidence of BPAR in the ECD and OD groups.

Carine Diet et al. Nephrol. Dial. Transplant. 2010;25:27452753

Proposal of Categorization of Expanded Criteria Donors in

Renal Transplantation
KOUKOULAKI, KYRIAKOPOULOS, NIKOLAIDIS ET AL.: Transplantation Proceedings, 46, 31683171 (2014)

ECD is defined as any brain-dead donor over the age of 60 years, or

a donor over the age of 50 years with two of the following: a history
of hypertension, terminal serum creatinine level above 1.5 mg/dL,
or death resulting from a cerebrovascular accident.
ECD type I included donors over the age of 60 years without any
risk factors (n = 20), ECD type II included donors with age between
50 and 59 years with 2 or 3 risk factors (n =25) and finally ECD type
III included donors with age above 60 years with at least one risk
factor (n = 41).

KOUKOULAKI,
KYRIAKOPOULOS, NIKOLAIDIS
ET AL.: Transplantation
Proceedings, 46, 3168- 3171
(2014)

Machine perfusion versus cold storage for the preservation of kidneys from donors 65 years allocated
in the Eurotransplant Senior Programme
The 1-year graft survival rate

Anja Gallinat et al. Nephrol. Dial. Transplant. 2012;27:44584463

The 1-year graft survival rate of kidney grafts with and without DGF. MP, machine perfusion;
CS, cold storage; DGF, delayed graft function; the log-rank test of equality: MP versus CS in
kidneys without DGF, P = 0.11; MP versus CS in kidneys with DGF, P = 0.01; DGF versus no
DGF within CS group, P < 0.0001; DGF versus no DGF within MP group, P = 0.27.

Anja Gallinat et al. Nephrol. Dial. Transplant. 2012;27:44584463

Outcomes of Kidney Transplantation From Older Living Donors

Lim et al., Transplantation 2013;95: 106-113

Cumulative incidence function (CIF) of graft failure (A) and Kaplan-Meier curve of patient
survival (B) among recipients of kidneys from live donors age 70 (LD70) versus matched
controls from among recipients of live donors age 50 to 59 (LD50) and nonexten...

Jonathan C. Berger et al. CJASN 2011;6:2887-2893

The interplay between old recipient and

kidney from old donor
From Heinbokel et al.: Immunosenescence and transplant
outcome. Transplant Int, 2013, 26,242-253

Meijers RWJ et al . T-cell ageing in end-stage renal disease patients

World Journal of Nephrology,
2014, 3, 268-276

Impaired B-cell proliferation

Alexiewicz J., Klinger M., Pitts T. et al.: J. Am. Soc. Nephrol. 1990; 1:236-244

Premature aging of circulating T cells in patients with end-stage renal disease

MGH Betjes et al.; Kidney International (2011) 80, 208217

Meijers RWJ et al . T-cell ageing in end-stage renal disease patients

Based on the analyses of the T-cell ageing

parameters, i.e., assessment of TRECcontent, relative telomere length and
differentiation status we showed that the
immunological age of ESRD patients is
advanced by 20 years compared to their
calendar age.

In fact, majority of transplanted patients

are elderly in terms of immune system
state

Transplant International; 21 (2008) 661668

CD8 T cells in patients with restricted TCR V repertoire exhibit potent effector functions
(secretion of proinflammatory cytokines [TNF- and IFN-] and cytotoxic function).

Michelle Yap et al. JASN 2014;25:1856-1868

Identification of patients at risk of late kidney dysfunction based on the features of CD8 T
cells.

Michelle Yap et al. JASN 2014;25:1856-1868

Summary
Despite compromised repair mechanisms,

increased susceptiblity to ischemia-reperfusion

injury, stronger immunogenicity, the organs from
old donors can be successfully used for kidney
transplantation, especially for elderly recipients.