Effect of age on kidney transplants.
1. Graft survival rates ranged from 72-78% at 1 year for recipients over the age of 6 years. Only the very young pediatric recipients had a low 64% 1-year graft survival rate. 2. Older recipients (over 55 years) had a significantly lower 1-year patient survival rate. When we considered death with a functioning graft as a transplant success, older patients actually had the highest graft survival rate. 3. Donor age had an overriding effect on graft survival. The 1-year graft survival rates were 78% for recipients of kidneys from adult donors, 59% from younger pediatric donors, and 67% from older donors. 4. One-year graft survival rates were uniformly over 80% in transplants with no HLA-B,DR antigens mismatched, regardless of recipient or donor age (except when the donor was over 55). The 1-year survival rate for younger pediatric donor kidneys was 62% or less when there were HLA-B,DR mismatches. 5. Pretransplant transfusions improved graft survival by 2-4% in recipients of adult donor kidneys. In recipients of younger pediatric kidneys, graft survival improved by 20% at 1 year with 1-2 transfusions. The enhancing effect of transfusions and matching in recipients of smaller pediatric kidneys is consistent with the idea that these kidneys are more vulnerable to rejection than those from adult donors. 6. Pediatric donors (younger than 15 years of age) accounted for approximately 15% of all donors, whereas pediatric recipients only constituted 2.8% of all recipients in the period of 1984 to 1988. Most kidneys derived from pediatric donors have to be given to adult or older recipients.
Zhou
Y C
YC
Cecka
J M
JM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003524:Cyclosporins / Q000627:therapeutic use; D006085:Graft Survival; D006680:HLA Antigens; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000276:immunology / Q000706:statistics & numerical data; D008875:Middle Aged; D012042:Registries; D014019:Tissue Donors
D003524:Cyclosporins; D006680:HLA Antigens