Outcomes of transplanting deceased-donor kidneys between elderly donors and recipients.
Rate of acceptance of deceased-donor kidneys decreases with donor age despite the growing number of aged transplant candidates on the waiting list. In the Eurotransplant Senior Program, HLA-unmatched kidneys from deceased donors aged > or = 65 yr are transplanted regionally into recipients aged > or = 65 yr. Because we have become more willing to accept kidneys from donors aged > or = 75 yr than previous years, we performed a retrospective analysis of this subgroup. Kidneys were accepted from donors aged > or = 75 yr provided a normal creatinine on admission to the hospital, a Cockcroft-Gault creatinine clearance > 80 ml/min, and an absence of comorbidities. We compared outcomes of kidneys from donors aged > or = 75 yr with both younger-donor kidneys transplanted in the Eurotransplant Senior Program and with younger-donor HLA-matched kidneys transplanted into recipients > or = 60 yr. There were no differences in 5-yr graft and patient survival or rate of delayed graft function between groups. Graft function, measured by creatinine and creatinine clearance, differed without pattern at only three of 12 time points during 5 yr of follow-up. In conclusion, our data suggest that kidneys from deceased donors aged > or = 75 yr can be transplanted safely into recipients aged > or = 65 yr if similar donor criteria and local allocation practices are used.
Giessing
Markus
M
Department of Urology, Heinrich Heine University Hospital, Moorenstr. 5, D-40225 Duesseldorf, Germany. markus.giessing@med.uni-duesseldorf.de
Fuller
T Florian
TF
Friedersdorff
Frank
F
Deger
Serdar
S
Wille
Andreas
A
Neumayer
Hans-Hellmut
HH
Schmidt
Danilo
D
Budde
Klemens
K
Liefeldt
Lutz
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality; D008875:Middle Aged; D014019:Tissue Donors; D016896:Treatment Outcome