title: Kidney transplantation from older donors.
abstract: BACKGROUND
  The use of kidneys from older donors has become generally accepted and increasingly common, despite the knowledge that donor age is a well-known risk factor for graft failure.
  
  
  OBJECTIVE
  To review our experience with the utilization of kidneys from donors older than 60 years.
  
  
  METHODS
  Among two hundred eight patients, 32 (group A) received an organ obtained from a donor older than 60 years. The organs were age-matched with a maximum gap of 20 years between donors and recipients. Organs from older donors were assigned to recipients presenting a body mass index lower than that of the donor. The primary end point was patient and graft survival. Secondary endpoints were incidences of delayed graft function and of acute rejection episodes as well as renal function at 3 months and yearly.
  
  
  RESULTS
  The two groups were comparable in terms of demographic features, indications for transplantation, comorbidities, as well as cold and warm ischemia times. The Mean lengths of follow up were 31.4 ± 20.3 months and 30.3 ± 20.1 months, respectively. Graft and patient survivals were comparable. Mean creatinine values at the study intervals were significantly lower among group B who received grafts from younger donors. The incidence of delayed graft function and acute rejection episodes were similar: 15.6% (5/32) versus 20.5% (36/176; P=0.35) and 15.6% (5/32) and 12.1% (21/167; P=0.136) in groups A and B, respectively.
  
  
  CONCLUSIONS
  Donor age older than 60 years showed a negative impact on kidney function. Though, given the escalating disparity between organ supply and demand, this precious source of organs cannot be neglected. We need better ways to use the available organs.
authors.affiliation: Nuffield Department of Surgery, University of Oxford, Oxford, UK. dcp.doc@libero.it
authors.forename: P
authors.initials: P
authors.lastname: Di Cocco
authors.forename: G
authors.initials: G
authors.lastname: Orlando
authors.forename: V
authors.initials: V
authors.lastname: Rizza
authors.forename: L
authors.initials: L
authors.lastname: De Luca
authors.forename: M
authors.initials: M
authors.lastname: D'Angelo
authors.forename: K
authors.initials: K
authors.lastname: Clemente
authors.forename: A
authors.initials: A
authors.lastname: Famulari
authors.forename: F
authors.initials: F
authors.lastname: Pisani
mesh_terms: D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000209:etiology; D046148:Donor Selection; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003404:Creatinine