European Senior Programme: Single Centre Experience in Münster (Germany)

Background: In 1999 Eurotransplant launched the European Senior Programme (ESP). The aim of this programme was to shorten the cold ischemic time (CIT) for donors and recipients aged 3 65 years by leaving out HLA matching prior allocation as well as regional allocation of the kidney with short transportation times. We report our experiences with the ESP.Patients and Methods: From 1999 to 2007 837 kidney transplantations were performed at our centre. 112 (13,3%) were allocated in the ESP. Data from these patients were evaluated retrospectively. The follow-up was 12-96 months. A special emphasis was put on the cold ischemic time.Results: From 1999 to 2007 112 ESP kidney transplantations were performed. Compared with regular allocation (n=724) a reduced mean cold ischemic time has been achieved (11.7 ± 5.1 h (3.9-24.5) versus 15.6 ± 4.8 h (5.1-34.0). 68.9 % (77) of the kidneys showed primary function, 27.6% (n=31) showed delayed graft function and in 3.5% (n=4) a primary non-function was stated. After 12 months mean creatinine was 1.7±0.8mg/dl, after 24 months 1.9±0.7mg/dl and after 36 months 2.0±0.9mg/dl. After five years 65.2% of ESP kidneys still showed function (n=46).Conclusion: Since initiation of the ESP the cold ischemic time could be reduced effectively for these kidneys in comparison to the regular allocation. Thus a good transplant function could be realised. To achieve this, besides the ESP Allocation system perfect logistics in the transplant centre is mandatory. This means excellent work up of senior recipients on the waiting list as well as immediate transplantation even in parallel cases as soon as the graft arrives at the centre.