Negative impact of 'old-to-old' donations on success of cadaveric renal transplants.
The effect of 'old-to-old' cadaveric renal transplants on operative complications and graft survival was assessed in all 325 patients undergoing solitary cadaveric renal transplantations in Israel during a 3-yr period. Preoperative information and hospital course data were abstracted from the charts. Results were analyzed using Kaplan-Meyer survival curves, univariate and multivariate Cox models. Overall, 62 (19.1%) grafts failed within a year. Failure rate was 46.2% for 'old-to-old' transplants compared with 15.5% for all other donor/recipient age combinations (p < 0.0001). 'Old-to-old' transplants remained independently associated with graft failure in a multivariate Cox model after controlling the effect of other risk factors. 'Old-to-old' transplants were also associated with increased operative complications relative to other age combinations. The decision to use 'old-to-old' transplants, even when donors are scarce, is problematic and should be reconsidered.
Weiss-Salz
Inbal
I
The Department of Health Services Research, Ministry of Health, Jerusalem, Israel.
Mandel
Micha
M
Galai
Noya
N
Boner
Geoffrey
G
Mor
Eytan
E
Nakache
Richard
R
Simchen
Elisheva
E
D000367:Age Factors; D002102:Cadaver; D005260:Female; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D016019:Survival Analysis