title: Living donor age and kidney allograft half-life: implications for living donor paired exchange programs.
abstract: OBJECTIVE
  Living donor paired exchange programs assume that kidneys from living donors are of comparable quality and anticipated longevity. This study determined actual allograft t(1/2) within different recipient age groups (10-year increments) as a function of donor age (5-year increments), and juxtaposed these results against the probabilities of deceased donor transplantation, and exclusion from transplantation (death or removal from the wait-list).
  
  
  METHODS
  Data from the US Renal Data System (transplant dates 1988-2003 with follow-up through September 2007) were used to determine allograft t(1/2), whereas data from patients on the United Network for Organ Sharing waiting list between 2003 and 2005 (with follow-up through February 2010) were used to determine wait-list outcomes.
  
  
  RESULTS
  With the exception of recipients aged 18-39 years, who had the best outcomes with donors aged 18-39 years, living donor age between 18 and 64 years had minimal effect on allograft t(1/2) (difference of 1-2 years with no graded association). The probability of deceased donor transplantation after 3 years of wait-listing ranged from 21% to 66% by blood type and level of sensitization, whereas the probability of being excluded from transplantation ranged from 6% to 27% by age, race, and primary renal disease.
  
  
  CONCLUSIONS
  With the exception of recipients aged 18-39 years, living donor age between 18 and 64 years has minimal effect on allograft survival.
authors.affiliation: St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Chang
authors.forename: Jagbir
authors.initials: J
authors.lastname: Gill
authors.forename: James
authors.initials: J
authors.lastname: Dong
authors.forename: Caren
authors.initials: C
authors.lastname: Rose
authors.forename: Howard
authors.initials: H
authors.lastname: Yan
authors.forename: David
authors.initials: D
authors.lastname: Landsberg
authors.forename: Edward H
authors.initials: EH
authors.lastname: Cole
authors.forename: John S
authors.initials: JS
authors.lastname: Gill
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016208:Databases, Factual; D005260:Female; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000706:statistics & numerical data*; D014850:Waiting Lists / Q000401:mortality*; D055815:Young Adult