Donor Age Groups Research Articles

Kidney transplantation outcomes for adult recipients of pediatric donor kidneys.

Despite a paucity of data assessing transplantation of deceased-donor pediatric donor kidneys into adult recipients, utilization of pediatric organs is declining in the UK, likely due to concerns that such organs may have inferior outcomes. However, we hypothesized that these concerns may be unfounded. As such, the aim of the study was to compare kidney transplant outcomes between adult recipients of pediatric and adult deceased-donor organs. Data were collected from the UK Transplant Registry for all adult (18+ years) deceased-donor single-kidney transplant recipients between January 2000 and January 2016. Univariable and multivariable analyses were undertaken, to compare a range of outcomes between recipients of kidneys from pediatric and adult donors. Transplants were stratified by the donor age (years) as follows: 0-16 (n=666), 17-18 (n=465), and 19-44 (n=7378). Recipients of pediatric donor kidneys were observed to have improved long-term graft function, with a median creatinine at 1year of 109 vs. 117μmol/L for recipients of donors aged 0-16 vs. 19-44years (P<.001). However, on multivariable analysis, this was not found to correspond to a significant difference in patient (P=.914) or graft survival (P=.190) between the donor age groups. Subgroup analysis within the younger donors found no significant differences in recipient outcomes between donors aged 0-6, 7-12, and 13-16years. In this population cohort study, we identified excellent outcomes among adult recipients of pediatric donor kidneys. Pediatric donors are a valuable source of organs for adult recipients in an era where organ demand is rising.

Kidney transplant outcomes from donation after circulatory death donors of advanced age.

Continued comparison of kidney transplant outcomes between older DCD and donation after brain death (DBD) donors is needed to safely expand the deceased donor pool. We performed a retrospective cohort study using the UNOS/OPTN transplant registry from donors >50years old between 1994 and 2016. Donor age was stratified into 4 groups: 50-54, 55-59, 60-64, and >65years old. Rates of delayed graft function (DGF) and primary non-function (PNF) were compared. Multivariable Cox regression models were constructed to identify factors associated with time to graft failure. The DCD donors within each age group had fewer comorbidities than the DBD donors. Graft survival for DCD kidneys was equivalent or superior to DBD kidneys in all donor age groups. DGF rates were significantly greater for DCD kidneys in all age groups. PNF rates across all groups were similar. In multivariable analysis, DCD status was not independently associated with time to all-cause graft failure in the 50-54 donor age group (HR=1.02, 95% CI=0.93-1.13), 55-59 donor age group (HR=1.07, 95% CI=0.96-1.19), or 60-64 donor age group (HR=1.135, 95% CI=0.97-1.32). Kidneys from carefully selected older DCD donors, particularly ages 50-64, are a potential means to safely expand the deceased donor pool.

Attenuated regenerative properties in human periodontal ligament-derived stem cells of older donor ages with shorter telomere length and lower SSEA4 expression.

Periodontal ligament (PDL) stem cell properties are critical in the periodontal tissue regeneration for periodontitis. Previously, we have demonstrated that cigarette smoking attenuates PDL-derived stem cell (PDLSC) regenerative properties. Here, we report the findings on the regenerative properties of human PDLSCs with different donor ages and the underlying mechanisms. Human PDLSCs from 18 independent donors were divided into different age groups (≤ 20, 20-40, and > 40years old). The proliferation of PDLSCs with donor age of ≤ 20years old was significantly higher than that of the 20-40- and > 40-years-old groups, whereas the migration of PDLSCs with donor age of ≤ 20 and 20-40years old was significantly higher than that of the > 40-years-old group. Moreover, the mesodermal lineage differentiation capabilities of PDLSCs were also higher in the donor age group of ≤ 20years old than the donor age of > 40years old. In addition, shorter telomere length and lower expression of SSEA4 were found in PDLSCs with donor age of > 40years old, compared with those with donor age of ≤ 20-years-old group. Besides, PDLSCs with donor age of 20-40 and > 40years old had higher IL6 and CXCL8 gene expressions. In summary, results from this study revealed the attenuated proliferation, migration, and mesodermal lineage differentiation properties in human PDLSCs with older donor ages. Donor age of PDLSCs should be considered as the selection criteria for the periodontal tissue regeneration treatment.

The Effect of Donor Age on Outcome after Allogeneic Hematopoietic Stem Cell Transplantation

<h3>Background</h3> The age of patients admitted to HSCT is increasing. The median age of adult patients is close to 60 years at many centers. With a sibling donor this means that in most cases an older donor will be used. There are reports that donor age is important for the outcome. <h3>Hypothesis</h3> Our hypothesis is that it may be better to select a young well matched (10/10 match) unrelated donor (MUD), if available, instead of an older matched related donor (MRD). <h3>Material</h3> In a homogenous material consisting of patients with myeloid malignancies (AML, MDS, MPN, CML) receiving a PBSC graft and myeloablative conditioning, CsA+MTX as GVHD prophylaxis without <i>in vivo</i>T-cell depletion (no ATG), we studied the effect of the donor age. For this reason we selected patients with a MRD and an older donor (≥40y) and a 10/10 MUD with a younger donor (<40y) for analysis. There were 53 patients with a MRD and 60 with a MUD. Among patients with a MRD the donor age was grouped into three separate categories: 40-50y (n=18), 51-60y (n=23) and >60y (n=12). In the MUD group donor age groups were: 18-25y (n=22) and 26-39y (n=38) (table 1). <h3>Results</h3> The best OS, RFS, TRM and GRFS were seen in the "MUD age 18-25y" group (Figure 1). No effect was seen on incidence of relapse and acute and chronic GVHD. In multivariate analysis, corrected for differences between the groups, we found that OS, RFS, TRM and GRFS were better in the "MUD age 18-25y" group, compared to the MRD groups (figure 1). <h3>Conclusion</h3> In cases where an older sibling donor is available, it may be reasonable to search for a well-matched young (<25y) MUD. However, this is a limited small, single center study. Larger studies are warranted.

Endothelial density analysis by age group of corneal donors in an eye bank in Paraná State, Brazil

Resumo Objetivo: Analisar a densidade endotelial das corneas doadas para transplante nas diferentes faixas etarias. Metodos: O estudo avaliou 244 corneas de 122 doadores de ambos os sexos no Banco de Olhos de Cascavel-PR a partir da analise de prontuarios medicos contendo a microscopia especular dos doadores. Resultados: A maioria dos doadores de cornea era do sexo masculino (67,2%). A idade media dos doadores foi 53,8 anos com variacoes entre 5 e 70 anos. A faixa etaria dos 61-70 anos com o maior numero de doacoes, correspondendo a quase 41% e a densidade media endotelial foi de 2645 celulas/mm² (variando de 1897 a 4201 celulas/mm²). Na primeira decada de vida, a densidade endotelial media foi 2923 celulas/mm²; na segunda decada 2757 celulas/mm²; na terceira 2846 celulas/mm²; na quarta 2627 celulas/mm²; na quinta decada, 2830 celulas/mm²; na sexta 2605 celulas/mm² e na setima decada de vida 2570 celulas/mm². Conclusao: Este estudo demonstrou que a densidade endotelial media das corneas doadas para transplante na primeira decada de vida (2923 celulas/mm²) quando comparada isoladamente a setima decada (2570 celulas/mm²) teve reducao. Ja na avaliacao da segunda ate a sexta decada nao houve um padrao, ora havendo acrescimo, ora decrescimo da densidade endotelial media.

Role of salt supplementation on vasovagal reactions in young whole blood donors

BackgroundThe physiologic interventions to prevent vasovagal reactions (VVRs) have been published evaluating water loading, applied muscle tension and salt loading on immediate VVRs (IVVRs), but the effect of salt on delayed VVRs (DVVRs) has not been evaluated.Materials and MethodsRandomized controlled study was conducted enrolling 3060 donors in age group 18–25 years. Control group (CG) donors were given 300 ml of sweetened lime water, with additional 2·5 g salt added in the test group (TG).ResultsThere were 90 VVRs in 3060 (2·94%, 1 in 34) young college‐going whole blood donors in the present study. This included 57 IVVRs (1·86%, 1 in 54) and 33 DVVRs (1·08%, 1 in 93). There were 53 VVRs (3·49%, 1 in 29) in the CG and 37 VVRs (2·39%, 1 in 57) in the TG, with absolute risk reduction (ARR) of 1·1%. There were 30 IVVRs (1·98%, 1 in 51) in CG and 27 IVVRs (1·74%, 1 in 57) in TG, with ARR of 0·2%%. Significantly, there were 23 DVVRs (1·51%, 1 in 67) in CG and only 10 DVVRs (0·65%, 1 in 154) in the TG, with ARR of 0·9%. One thousand (1000), five hundred (500) and one hundred and eleven (111) young whole donors need to be given 2·5 g of salt supplementation in fluid medium to prevent one VVR, IVVR and DVVR, respectively. The odds and the adjusted odds (AOR) of occurrence of DVVRs were 2·36, 95% CI (1·12–4·98) and 2·40, 95% CI (1·13–5·07) in the CG as against in the TG, on binary and multivariable logistic regression, respectively.ConclusionThere is an overall trend of decrease in VVRs with salt loading in young college‐going whole blood donors, which is statistically evident in the case of DVVRs.

Relationship between early proteinuria and long term outcome of kidney transplanted patients from different decades of donor age

BackgroundProteinuria after kidney transplantation portends a worse graft survival. However the magnitude of proteinuria related to patient and graft survival and its correlation with donor and recipient characteristics are poorly explored.MethodsThis study investigated the impact of post transplant proteinuria in the first year in 1127 kidney transplants analyzing the impact of different donor ages. Proteinuria cut off was set at 0.5 g/day.ResultsTransplants with proteinuria > 0.5 g/day correlated with poor graft and patient outcome in all donor age groups. In addition, 6-month-1-year proteinuria increase was significantly associated with graft outcome, especially with donors > 60 years old (p < 0.05; Odd Ratio 1.8). 1-year graft function (eGFR < or ≥ 44 ml/min) had similar impact to proteinuria (≥ 0.5 g/day) on graft failure (Hazard Ratio 2.77 vs Hazard Ratio 2.46). Low-grade proteinuria (0.2–0.5 g/day) demonstrated a trend for worse graft survival with increasing donor age. Also in kidney-paired analysis proteinuria ≥0.5 effect was more significant with donors > 50 years old (Odd Ratio 2.3).ConclusionsPost-transplant proteinuria was increasingly harmful with older donor age. Proteinuria ≥0.5 g/day correlates with worse outcomes in all transplanted patients. Prognostic value of proteinuria and eGFR for graft and patient survival was comparable and these two variables remain significant risk factors even in a multivariate model that take into consideration the most important clinical variables (donor age, rejection, delayed graft function and cytomegalovirus viremia among others).

A new approach to extend the storage of donor corneas after 28days of corneal culture in an Italian eye bank.

This study aimed to evaluate the possibility to extend the storage of unused organ-cultured donor corneas. After 28 days of corneal culture in TISSUE-C (AL.CHI.MI.A. S.R.L., Italy) and 5-day storage in transport/deswelling medium CARRY-C (AL.CHI.MI.A. S.R.L., Italy), 25 corneas that were deemed suitable for transplantation were transferred in fresh TISSUE-C at 31°C for additional 7days and then in fresh CARRY-C at room temperature for 24h. Tissues were assessed for endothelial cell density (ECD), endothelial mortality and morphology after the standard and the extended corneal storage. In addition, the effect of donor age < 85years and ≥ 85years on corneal characteristics was assessed. After the extended storage, 6 out of 25 tested corneas (24%) showed ECD values below the acceptance limit (< 2000cells/mm2). 19 corneas (76%) were still suitable for transplantation and showed a 5.9% loss in ECD, which was not statistically significant (P = 0.0949) compared to standard storage period. The two donor age groups did not show statistically significant differences in any tested parameter, although a trend for lower ECD and higher mortality in Descemet's folds after standard storage was observed in the ≥ 85 age donor group. Thus, the attempt of the current study to provide new sight-restorative options for unused tissues and increasing the availability of corneas in case of shortage gave encouraging results. Although a higher vulnerability of corneas from very old donors could not be statistically demonstrated in the present study, higher sample size could be required for prolonging the shelf life of these tissues.

Age Matters: Younger Unrelated PBSC Donors Experience Less G-CSF-Related Symptoms and Have a Faster Emotional Recovery Than Older Donors

Introduction Young adults are more likely to be selected as unrelated stem cell donors because younger donor age has been associated with improved overall survival for recipients. Younger donors are also less likely to have co-morbidities leading to cancellation at the donor medical. Due to this, donor recruitment policies target the young adult population, and in 2012 the Anthony Nolan Bone Marrow Registry lowered the recruitment age for donors from 18 to 16 years. Previously published studies of unrelated donor recovery and experience have not included donors under 18, and have included relatively low proportions of young adult donors. The aim of this study was to compare donor availability, stem cell yield, and recovery across donor age groups. Methods All sequential first peripheral blood stem cell (PBSC) donations to adult patients from unrelated donors at the Anthony Nolan Registry between May 2015 and September 2017 were analysed (n=879). The primary outcome was achievement of optimal collection yield (CD34+ ≥4x106 cells per kg patient weight) following 4 or 5 days of G-CSF (depending on whether 1 or 2-day collection were required). The secondary outcomes were turnaround time from verification typing stage to donation (to assess donor availability), and the incidence of complications post-donation (skeletal pain, general symptoms and emotional state) as well as self-reported recovery. Donors were grouped in age-based equal quartiles (17-22.9, 23-25.9, 26-30.9 and 31-60 year-old). Groups were compared using the chi-squared test, or chi-squared trend test for categorical variables, and the Kruskal-Wallis test for continuous variables. Follow-up data was collected prospectively via online questionnaires post-donation at day 2, day 7, day 30 and 1 year. Results Results by age group are presented in Table 1. There were no differences in the proportion of donors achieving the optimal CD34+ count (p=0.44) between the different age groups, regardless of the number of collection days required. Furthermore, no differences were found in the turnaround time from the verification typing stage to stem cell collection between younger and older donors (p=0.54). During G-CSF administration, older donors were more likely to suffer from bony pain (p=0.005) and general symptoms (such as anorexia, tiredness or night sweats) compared to younger donors (p=0.001). Two days post-collection, a higher number of younger donors reported emotional (p=0.001) and physical recovery (p=0.024) compared to older donors. Also older donors experienced more general symptoms after donation (p=0.036), and tiredness was particularly more prevalent among older donors at this time point (p=0.006). There was a trend in older donors reporting more bony pain than younger donors (p=0.062). One week after donation, there was a higher physical recovery rate in younger donors (p=0.015). Longer-term recovery did not differ by age. Conclusions Younger donors proceed to donation as quickly as older donors, and are equally effective in achieving the stem cell yield. Younger donors report fewer complications and experience a faster physical and emotional recovery following PBSC donation. In addition, G-CSF has a favourable side effect profile on this population. These results support recruitment of unrelated donors from 16 years of age and suggest that our current registry pathway for support of these donors is adequate. Follow-up is fundamental to address medical or psychological issues, and manage them accordingly, mainly within the first week post-donation and particularly in older donors. Disclosures No relevant conflicts of interest to declare.

LUNG TRANSPLANTATION IN COPD PATIENTS: IS DONOR AGE A FACTOR?

SESSION TITLE: Wednesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Patients diagnosed as chronic obstructive pulmonary diseases (COPD) are the candidates who receive the second most lung transplantation (LTx) at our center. As LTx is constrained by an inadequate number of donors, often suitable older donors are used in COPD cases. Many of these patients are candidates for either single or double LTx. Since current guidelines stipulate younger donors, we investigated the survival outcome of IPF patients receiving <=49 vs. >= 50 years old donor lungs. METHODS: Ninety three (93) COPD patients that underwent either single or double LTx at our center from February 2012 to March 2018 were reviewed retrospectively. 80 patients received organs from donor age <=49 and 13 patients received organs from donor age >= 50. Demographics, recipients' age and height, LAS, length of stay (LOS), survival days, death, types of induction, and types of surgical procedures were compared between the two groups for significance. Actuarial survival was assessed by Kaplan-Meier curve and compared by log-rank test. Data were expressed as mean ± standard deviation and p-value less than 0.05 was considered significant (Stata 14). RESULTS: Out of 93 COPD patients, demographics data showed no significant differences in recipients' age (p=0.27), gender (p=0.49), LAS (p=0.32), height (p=0.97), and BMI (p=0.17). Clinical parameters such as CPB on and off (p=0.79), Campath and Simulect induction (p=0.45), and antero-apical, clamshell, median sternotomy surgical approaches (p=0.77) did not show any significant differences comparing the two groups. Median length of stay was 17 days in both group (p=ns). Log-rank test for equality of survivor functions showed no difference between the two donor age groups (p=0.38). There was a trend towards gender significance (p=0.02) in <=49 donor age group (70M vs. 10F) and in >= 50 donor age group (8M vs. 5F). The donor age ranged from 15 to 60 years. Kaplan-Meier curve showed the survival outcome in two donor age groups (0.38). CONCLUSIONS: Outcomes after lung transplantation using donors aged 50 to 60 were similar to those observed with donors 15 to 49 years. There was a similar survival outcome in both groups. CLINICAL IMPLICATIONS: This study focuses on the older donors availability for lung transplantation in COPD patients. DISCLOSURES: no disclosure on file for STACEY BRANN; no disclosure on file for Jesus Gomez-Abraham; No relevant relationships by Mohammed Kashem, source=Web Response No relevant relationships by Suresh Keshavamurthy, source=Web Response No relevant relationships by Jacob Levy, source=Web Response No relevant relationships by Norihisa Shigemura, source=Web Response No relevant relationships by Gengo Sunagawa, source=Web Response no disclosure on file for Yoshiya Toyoda; no disclosure on file for Huaqing Zhao

BLOOD PRODUCTS TRANSFUSION DURING 2012-13 IN PESHAWAR, PAKISTAN

Background: Blood products transfusion has been a major treatment modality especially in critical care settings. The objectives of this study were to determine frequency and distribution of blood products transfusion in public and private health care facilities during 2012-2013 in Peshawar, Pakistan. Materials &amp; Methods: This cross-sectional, study was conducted in the Department of Pathology, Northwest School of Medicine, Peshawar, Pakistan from 1st January 2012 to 31st December 2013. Sample size was 2,04,942 blood products transfusion, selected through consecutive non probability technique. All allogeneic cases of transfusions in inpatient and emergency were included. A total of six public, one private and two stand-alone blood banks were enrolled into the study. Demographic variable were name of the health care facility, sex and age groups of donors. Research variables were type of blood products transfusion (whole blood, packed red blood cell, fresh frozen plasma, platelets). All variables being categorical were described as count and percentages. Data was analyzed using software SPSS version 23. Results: Out of 2,04,942 units, 1,33,212 (65%) were men and 71,730 (35%) women. Packed red blood cells were the most commonly used component with 80227 units (39.1%), whole blood 77655 units (37.8%), Fresh frozen plasma 35932 units (17.5%) and platelets 11128 units (5.6%). Blood products transfusion was 46927 units (22.89%) in 65 years. Conclusion: Modal group was men. Packed red blood cells were the most frequently transfused blood component in hospitals of Peshawar especially Lady reading hospital. Most common age group was 18-40 years. Whole blood still comprises a significant fraction of transfusions which is alarming.

Older Donor Age Is a Risk Factor for Negative Outcomes After Adult Living Donor Liver Transplantation Using Small-for-Size Grafts.

Adult-to-adult living donor liver transplantation (ALDLT) using small-for-size grafts (SFSGs), ie, a graft with a graft-to-recipient weight ratio (GRWR) <0.8%, has been a challenge that should be carefully dealt with, and risk factors in this category are unclear. Therefore, we aimed to examine the risk factors and outcomes of ALDLT using SFSGs over a 13-year period in 121 patients who had undergone their first ALDLT using SFSGs. Small-for-size syndrome (SFSS), early graft loss, and 1-year mortality were encountered in 21.6%, 14.9%, and 18.4% of patients, respectively. By multivariate analysis, older donor age (≥45 years) was an independent risk factor for SFSS (odds ratio [OR], 4.46; P=0.004), early graft loss (OR, 4.11; P=0.02), and 1-year mortality (OR, 3.76; P=0.02). Child-Pugh C class recipients were associated with a higher risk of SFSS development (P=0.013; OR, 7.44). Despite no significant difference between GRWR categories in the multivariate outcome analysis of the whole population, in the survival analysis of the 2 donor age groups, GRWR <0.6% was associated with significantly lower 1-year survival than the other GRWR categories in the younger donor group. Moreover, in the high final portal venous pressure (PVP) group (>15mmHg), younger ABO-compatible donors showed 100% 1-year survival with a significant difference from the group of other donors. Older donor age was an independent risk factor for SFSS, early graft loss, and 1-year mortality after ALDLT using SFSGs. GRWR should not be <0.6%, and PVP modulation is indicated when grafts from older or ABO-incompatible donors are used.

Donor Diabetes Mellitus Severity and Corneal Transplant Suitability in a US Eye Bank Donor Population.

To determine whether donor diabetes mellitus (DM) severity is associated with differences in endothelial cell density (ECD) and surgically unsuitable tissue. Raw data were obtained from Saving Sight Eye Bank (Kansas City, MO) including 10,454 donated eyes from 5346 eligible donors from July 2014 through May 2017. Donors were grouped into 5 categories by their insulin use and the presence of microvascular end-organ complications. The categories were non-DM (NDM), noninsulin-dependent DM without complications (NIDDMnc), noninsulin-dependent DM with complication (NIDDMc), insulin-dependent DM without complications, and insulin-dependent DM with complication. Outcome variables included ECD and tissue transplant suitability. Mixed effects models were used to adjust for the random effect of repeated measures and fixed effects of donor age, race, lens status, and death to refrigeration and death to preservation times. Interaction effects of DM severity group and donor age and DM severity group and lens status were included in the models. One thousand six hundred eighty-four (32.1%) donors had a diagnosis of DM. Six hundred fifty-eight donors were in the NIDDMnc group, 225 in the NIDDMc group, 404 in the insulin-dependent DM without complication group, and 397 in the insulin-dependent DM with complication group. Compared with non-DM, donors with DM were older (P < 0.001) and more likely to be pseudophakic (P < 0.001). DM severity groups did not affect adjusted ECD at mean donor age. There was no statistically significant ECD interaction between DM severity group and lens status. There was a statistically significant ECD crossover interaction with NIDDMnc and donor age (P < 0.001). In phakic eyes, NIDDMc was associated with a statistically significantly lower odds of transplant suitability (odds ratio 0.62, P = 0.006). DM severity does not affect lowering adjusted ECD at mean donor age. DM severity and pseudophakia were not associated with lower adjusted ECD. NIDDMnc was associated with an attenuation of the age-dependent decrease in ECD. NIDDMc was associated with decreased transplant suitability in phakic eyes. Future studies should include age, lens status, and interaction effects in their models of ECD and transplant suitability.

Blood donation from 2006 to 2015 in Zhejiang Province, China: annual consecutive cross-sectional studies

ObjectivesTo describe the basic demographical characteristics of whole blood donors in Zhejiang Province, China, from 2006 to 2015 and to examine the trends in individual characteristics associated with blood donation...

Risk factors for graft failure after penetrating keratoplasty.

The objective of our study was to define principal risk factors for graft failure in patients who underwent penetrating keratoplasty (PK).Retrospective data obtained from a cohort of 895 penetrating keratoplasties performed between 2001 and 2006 were analysed. Recipient related factors, graft characteristics, and surgical technique were assessed in a univariate analysis and with a multivariate proportional hazard model to detect principal risk factors for definitive graft failure.Multivariate analysis showed clear significance for diagnosis and number of previous grafts and border line significance for the oldest donor age group. Patients with keratoconus had the best 10-year survival estimate (95%), followed by endothelial and stromal dystrophies (both 55%), infectious leukomas (49%), trauma (33%) and chemical burns (14%). Primary PK grafts had a survival rate of 81%, second grafts of 33% and third or more grafts of 16%. Overall 10-year survival estimate based on univariate analysis was found to be 65%.In conclusion, we found that primary diagnosis and previous graft failures in the recipient are the most important risk factors of graft failure after a PK.

PREVALENCE OF ABO AND RHESUS BLOOD GROUPS IN BLOOD DONORS. A STUDY FROM A TERTIARY CARE TEACHING HOSPITAL S.V.R.R.GOVT. GENERAL HOSPITAL IN RAYALASEEMA REGION OF ANDHRA PRADESH, TIRUPATI.

Back ground: The ABO and Rhesus –D blood group are the major blood group systems. The frequency of four main blood group systems varies in population throughout the world and even in different parts of the country. ABO &amp; Rh blood group antigens play a Vital role in immunologic safety of whole blood and blood component transfusion and also useful in population genetic studies, in resolving medico legal issues.&#x0D; Aim: This study is aimed to document the frequency and distribution pattern of ABO and Rh among blood donors in S.V.R.R.Govt. General Hospital, Tirupati.&#x0D; Study Design: It is a retrospective record based study carried out at Model blood bank S.V.R.R.Govt. General Hospital Tirupati from January 2014 to December 2015.&#x0D; Material and Methods: The study was conducted on 13,040 donors. ABO and Rh typing was done by using slide agglutination method with antisera ABO and Rh (tulip Diag). Doubtful cases were confirmed by tube agglutination method and reverse grouping by using pooled A&amp; B cells. The age group and sex of donors and frequency of ABO and Rh blood groups were reported in simple percentages.&#x0D; Results: In the present study the most common blood group was ‘O’ 5505 (42.2%) and least common being AB 778 (5.96%). The prevalence of Rh positive and negative distribution in the study population is 12267(94.07%) and 773(5.93%) respectively. Predominant donors belonged to age group between 18-35 years (85.37 %).Male donors (97.88%) are common than female donors (2.12%) with ratio. Blood group frequency with respect to ABO and Rh was found to be O&gt;B&gt;A&gt;AB.&#x0D; Conclusion: O positive blood group is significantly high in our population while AB Iis least.. Blood donation by females appears to be low provably because of illiteracy, malnutrition and social taboo. So female donor need to be motivated for blood donation. Knowledge of frequencies of different blood groups is very important for blood banks and transfusion service polices for better use and good inventory of blood units.&#x0D; Key words: Blood groups ABO, Rh

Older donor age is the risk factor for negative outcomes after adult living donor liver transplantation using small-for-size grafts

Introduction: Adult-to-adult living donor liver transplantation (ALDLT) using small for size grafts (SFSGs) (graft-to-recipient weight ratio (GRWR) < 0.8%) has been a challenge that should be carefully dealt with and risk factors in this category are unclear. Method: We aimed to examine the risk factors and outcomes of ALDLT using SFSGs in 121 patients who had undergone their first ALDLT using SFSGs over a 13-year-period. Result: Small-for-size syndrome (SFSS), early graft loss and 1-year mortality were encountered in 21.6%, 15.1% and 18.4% of patients, respectively. By multivariate analysis, older donor age (≥ 45 years) was an independent risk factor for SFSS, with early graft loss and 1-year mortality P values of 0.004, 0.02 and 0.02 and odds ratios (OR) of 4.46, 4.11 and 3.76, respectively. Child-Pugh C-class recipients were associated with a higher risk of SFSS development (P=0.013, OR 7.44). Despite no significant difference between GRWR% categories in the multivariate outcome analysis of the whole population, in the survival analysis of the two donor age groups, GRWR < 0.6% was associated with significantly lower 1-year survival than the other GRWR% categories in the younger donor group. Moreover, in the high final portal venous pressure (PVP) group (> 15 mmHg), younger ABO compatible donors showed 100% 1-year survival with a significant difference from the group of other donors. Conclusion: Older donor age was an independent risk factor for SFSS, early graft loss and 1-year mortality after ALDLT using SFSGs. GRWR should not be lower than 0.6% and PVP modulation is indicated when grafts from older or ABO incompatible donors are used.

The SENIORLAB study in the quest for healthy elderly patients

Abstract Reference intervals (RIs) for laboratory analyses by and large, are provided by analytical platform providers – the provenience and preanalytics of materials for the calculation of intervals often remain arcane particularly relating to the age group of donors. In an observational, prospective cohort study on 1467 healthy uniracial Caucasian residents &gt;60 years of age, 105 frequently used lab tests were done on one blood sample. With a nonrestrictive definition of health, several pathological lab results pointing to occult disease have been found and published from SENIORLAB so far. The RIs found for hemoglobin in women went from 117.9 to 152.4 g/L (80–84 years) and in men from 124.9 to 170.6 g/L (90% confidence interval [CI]). This article lists RIs computed with SENIORLAB data for such frequently ordered analyses as platelet counts, vitamin B12 and folate, ferritin and analytes measured to estimate metabolic performance in glucose turnover. In fact, 64.5% of the cohort showed prediabetic fasting plasma glucose (FPG) and/or glycated hemoglobin (HbA1c); total serum folate levels but not red blood cell folate decreased with progressing age. As much as 66% of evaluable study participants had insufficient levels of 25(OH) vitamin D. Published reports from SENIORLAB are referenced in this article.

Clinical Outcomes in Recipients of Living-Donor Kidney Transplantation by Donor Age Group

Clinical Outcomes in Recipients of Living-Donor Kidney Transplantation by Donor Age Group

Differentiating Donor Age Groups Based on Raman Spectroscopy of Bloodstains for Forensic Purposes.

Developments in analytical chemistry technologies and portable instrumentation over the past decade have contributed significantly to a variety of applications ranging from point of care testing to industrial process control. In particular, Raman spectroscopy has advanced for analyzing various types of evidence for forensic purposes. Extracting phenotypic information (e.g., sex, race, age, etc.) from body fluid traces is highly desirable for criminal investigations. Identifying the chronological age (CA) of a blood donor can provide significant assistance to detectives. In this proof-of-concept study, Raman spectroscopy and chemometrics have been used to analyze blood from human donors, and differentiate between them based on their CA [i.e., newborns (CA of <1 year), adolescents (CA of 11–13 years), and adults (CA of 43–68 years)]. A support vector machines discriminant analysis (SVMDA) model was constructed, which demonstrated high accuracy in correctly predicting blood donors’ age groups where the lowest cross-validated sensitivity and specificity values were 0.96 and 0.97, respectively. Overall, this preliminary study demonstrates the high selectivity of Raman spectroscopy for differentiating between blood donors based on their CA. The demonstrated capability completes our suite of phenotype profiling methodologies including the determination of sex and race. CA determination has particular importance since this characteristic cannot be determined through DNA profiling unlike sex and race. When completed, the developed methodology should allow for phenotype profiling based on dry traces of body fluids immediately at the scene of a crime. The availability of this information within the first few hours since the crime discovery could be invaluable for the investigation.