title: Does donor-recipient age difference matter in outcome of kidney transplantation? Implications for kidney paired donation.
abstract: BACKGROUND
  Kidney paired donation (KPD) is a rapidly growing modality for facilitating living donor kidney transplantation (LDKTx) for patients who are incompatible with their healthy, willing and living donor. The impact of donor-recipient age difference on long and short-term graft and patient survivals in LDKTx is still uncertain.
  
  
  METHODS
  A total of 1502 LDKTx recipients who received regular follow-up in our center from 1999 to 2012 were studied. Donor-recipient age difference was divided into subgroups (donor-recipient 0-10, 11-20, 0-20, 21-30, 31-40, and 21-40 years). Outcome measures included death censored graft, patient survival and acute rejection rate.
  
  
  RESULTS
  The 1-, 5-, 10-year patient survival of the donor-recipient age difference ≤20 years group showed no difference compared with the age difference >20 years group (94.5%, 83.2%, 71.9% and 95.2%, 86%, 77.8%, p = 0.053). The 1-, 5-, 10-year graft survival of the donor-recipient age difference ≤20 years group showed no difference compared with the age difference >20 years group (94.6%, 81.6%, 72.1% and 94%, 80%, 72.2%, p = 0.989). The rejection were also similar (17.5% vs. 16.5%, p > 0.05). There was no statistically significant difference in graft survival and acute rejection rate in all subgroups.
  
  
  CONCLUSIONS
  Older donors (usually within families) are not associated with worse outcome is reassuring. KPD should not be prohibited due to high donor-recipient age difference, when size of donor pool is small as in single center KPD program.
authors.affiliation: Department of Nephrology and Clinical Transplantation, Institute of Kidney Diseases and Research Center, Dr. HL Trivedi Institute of Transplantation Sciences (IKDRC-ITS) , Ahmedabad , India .
authors.forename: Vivek B
authors.initials: VB
authors.lastname: Kute
authors.forename: Aruna V
authors.initials: AV
authors.lastname: Vanikar
authors.forename: Pankaj R
authors.initials: PR
authors.lastname: Shah
authors.forename: Manoj R
authors.initials: MR
authors.lastname: Gumber
authors.forename: Himanshu V
authors.initials: HV
authors.lastname: Patel
authors.forename: Divyesh P
authors.initials: DP
authors.lastname: Engineer
authors.forename: Pranjal R
authors.initials: PR
authors.lastname: Modi
authors.forename: Veena R
authors.initials: VR
authors.lastname: Shah
authors.forename: Hargovind L
authors.initials: HL
authors.lastname: Trivedi
mesh_terms: D000328:Adult; D000367:Age Factors; D046148:Donor Selection / Q000706:statistics & numerical data; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality*; D019520:Living Donors / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult