title: Outcome of kidney transplantation from elderly donors after cardiac death.
abstract: BACKGROUND
  The rate of renal transplantation is limited by the number of donor organs available. A valuable source of organs is currently supplied by donation after cardiac death (DCD). At the Richard Bright Renal Unit, we have expanded our criteria for DCD, increasing the upper age limit for donation from 65 to 70.
  
  
  METHODS
  We performed a retrospective analysis of all DCD recipients between 2003 and 2009. We compared outcomes for patients age<60 versus >60 as measured by delayed graft function and estimated glomerular filtration rate (eGFR) and incidence of graft failure.
  
  
  RESULTS
  One hundred thirty-six DCD transplantations took place. Our early data showed excellent results for non-heart-beating donation. Over the last 7 years, the average age of DCD donors has increased from 43 in 2003 to 50 in 2009. The increase in age has been correlated with a decrease in average recipient eGFR from 59 in 2003 to 32 in 2009. Recipients of kidneys from older DCD donors (>60) have significantly lower eGFRs at 1 month and 1 year compared to kidneys from donors aged <60. The incidence of delayed graft function in recipients of kidneys from donors aged>60 was 71% compared to 40% for <60 age group. Despite this, we have not found any evidence of higher graft failure rates in the recipients of grafts from the >60 donor age group.
  
  
  CONCLUSIONS
  Expanding the age limits of our DCD donor program has led to an increased average donor age, reduced average eGFR, and increased delayed graft function. There is no evidence of reduced graft survival.
authors.affiliation: Department of General Surgery, Southmead Hospital, Birstol, UK. thorntonsimon@hotmail.com
authors.forename: S R
authors.initials: SR
authors.lastname: Thornton
authors.forename: N
authors.initials: N
authors.lastname: Hamilton
authors.forename: D
authors.initials: D
authors.lastname: Evans
authors.forename: T
authors.initials: T
authors.lastname: Fleming
authors.forename: E
authors.initials: E
authors.lastname: Clarke
authors.forename: J
authors.initials: J
authors.lastname: Morgan
authors.forename: N
authors.initials: N
authors.lastname: Kadi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D051799:Delayed Graft Function / Q000209:etiology / Q000503:physiopathology; D004739:England; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome