title: Advanced donor age alone is not a risk factor for graft survival in kidney transplantation.
abstract: BACKGROUND
  The use of kidneys from elderly deceased donors has substantially increased organ supply, although it is associated with worse graft function and survival rates. The risk of kidneys from elderly donors as well as expanded criteria donors (ECDs) on kidney transplant outcome was investigated.
  
  
  METHODS
  Seventy-five kidney transplants from ECDs over a 5-year period were reviewed retrospectively. Old age and increased donor risk variables were analyzed separately in relation to graft function and survival.
  
  
  RESULTS
  Sixty-four of 75 (85.3%) recipients had functioning grafts 5 years posttransplant. The overall actuarial graft survivals from 1 to 5 years were 87.5%, 68.1%, 57.3%, 55.4%, and 47.3%, respectively. Early graft function gave 47 (62.7%) kidneys remarkable actuarial survivals of 100.0%, 88.3%, 75.8%, 75.8%, and 68.4% at 1 to 5 years posttransplant, and 28 (37.3%) kidneys had delayed graft function with substantially decreased actuarial survival rates, ranging from 66.7% to 23.2%. Kidneys from elderly donors had considerable actuarial graft survival rates of 100.0%, 83.3%, 76.9%, 76.9%, and 67.0% from 1 to 5 years, respectively; these were the best graft survival rates compared with kidneys from the other donor categories. The other donor risk variables when associated with advanced age of any had an adverse effect on recipient graft function and survival, but no single risk variable alone, or a combination of any two, showed any statistically significant variability.
  
  
  CONCLUSIONS
  Elderly kidney donors provided a substantial organ pool expansion without affecting patient and graft survival in many patients. ECDs can be utilized safely if adequate measures are taken.
authors.affiliation: Second Propedeutic Department of Surgery, University of Athens, Medical School, General Hospital Laiko, Athens, Greece. tkaratz@med.uoa.gr
authors.forename: T
authors.initials: T
authors.lastname: Karatzas
authors.forename: J
authors.initials: J
authors.lastname: Bokos
authors.forename: A
authors.initials: A
authors.lastname: Katsargyris
authors.forename: K
authors.initials: K
authors.lastname: Diles
authors.forename: G
authors.initials: G
authors.lastname: Sotirchos
authors.forename: A
authors.initials: A
authors.lastname: Barlas
authors.forename: E
authors.initials: E
authors.lastname: Theodoropoulou
authors.forename: J
authors.initials: J
authors.lastname: Boletis
authors.forename: G
authors.initials: G
authors.lastname: Zavos
mesh_terms: D000367:Age Factors; D000368:Aged; D006085:Graft Survival; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D012189:Retrospective Studies; D014019:Tissue Donors