The impact of donor and recipient age on the outcome of kidney transplantation.
BACKGROUND
As survival has improved in the general population over the last few decades, the age of patients participating in renal transplantation has also increased. This study sought to investigate the impact of donor and recipient age as predictors of long-term graft survival in renal transplantation.


METHODS
We analyzed transplantation outcomes in 598 patients who received renal transplants from 1979 to 2002. Patients were divided into 4 groups according to their age at renal transplantation. Group A (donor age <50 years, recipient age >50 years, n = 19/3.2%); group B (donor age >50 years, recipient age <50 years, n = 153/25.5%); group C (donor age <50 years, recipient age >50 years, n = 69/11.6%), and group D (donor age <50 years, recipient age <50 years, n = 357/59.8%). Univariate analysis to assess the effect of donor and recipient age as predictor factors of graft outcome was complimented by Kaplan-Meier and log-rank methods to assess graft survival with P < 1.05 considered significant.


RESULTS
In the elderly donor group, graft survival was 92.8% at 1 year and 85.6% at 3 years; in the younger donor group, they were 93.4% and 90.2%, respectively, a difference that was statistically significant (P = .02). Univariate analysis of age factors showed a significant reduction in graft survival among recipients who received kidneys transplants from donors older than 50 years, although recipient age >50 years was not found to be an independent risk factor. The incidence of acute rejection was 24.6% in the elderly donor group and 23.5% in the younger donor group (P = not significant). Among the 4 groups, the best result was group D with 1-year and 3-year graft survival rates of 93.3% and 90.5%, respectively, but this result was not statistically significant.


CONCLUSIONS
These results may help the design for transplantation strategies for kidneys procured from elderly donors and for allocation to elderly recipients.
Kwon
O J
OJ
Department of Surgery, College of Medicine, Hanyang University, Seoul, Korea. ojkwon@hanyang.ac.kr
Lee
H G
HG
Kwak
J Y
JY
D000328:Adult; D000367:Age Factors; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival / Q000502:physiology*; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data*; D016896:Treatment Outcome