title: Single-center experience with kidney transplantation using deceased donors older than 75 years.
abstract: BACKGROUND
  Use of kidneys from donors aged 75 years and older is controversial. The purpose of this study was to evaluate the outcome of kidney transplantation (KT) involving these expanded criteria donors.
  
  
  METHODS
  From January 2001 to November 2009, 52 patients were transplanted with grafts from deceased donors aged 75 years and older. Donor and recipient data and intra- and postoperative variables were analyzed by univariate and multivariate regression analyses. Graft and patient survival were calculated using the Kaplan-Meier method.
  
  
  RESULTS
  Forty-one single and 11 double KTs were performed. Median recipient age was 66 years. After a median follow-up of 30 months, 37 of 52 patients are alive, 30 with functioning grafts (81%). Graft and patient survival rates at 3 and 5 years are 63% and 53%, and 78% and 64%, respectively. Double KT was significant predictor for graft survival by multivariate analysis. Five-year graft survival for single and double KT was 41% and 90%, respectively (P=0.0394). Comorbidity Index, hospital stay, acute rejection reaction, re-KT, and induction immunosuppressive therapy with interleukin-2 were significant predictors for patient survival by univariate analysis. Hospital stay and induction immunosuppression therapy reached multivariate significance. Double KT, cold ischemia time, and Comorbidity Index were found potential predictors of delayed graft function in our series.
  
  
  CONCLUSIONS
  Fairly good long-term outcome of KT from donors aged 75 years and older can be achieved in elderly recipients with low comorbidities when dual kidney grafting is used and when re-transplantations and high grade surgical complications are avoided.
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Gallinat
authors.forename: Thorsten
authors.initials: T
authors.lastname: Feldkamp
authors.forename: Randolph
authors.initials: R
authors.lastname: Schaffer
authors.forename: Sonia
authors.initials: S
authors.lastname: Radünz
authors.forename: Jürgen W
authors.initials: JW
authors.lastname: Treckmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Minor
authors.forename: Oliver
authors.initials: O
authors.lastname: Witzke
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Sotiropoulos
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D046148:Donor Selection / Q000379:methods*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D014019:Tissue Donors; D016896:Treatment Outcome