title: Influence of recipient age on deceased donor kidney transplant outcomes in the expanded criteria donor era.
abstract: METHODS
  We performed a retrospective single-center review of 884 deceased donor (DD) kidney transplants (KTs) in patients (pts) aged ≥40 yr.
  
  
  RESULTS
  One hundred and four (11.8%) pts were ≥70 (mean 74), 286 (32.3%) were 60-69 (mean 64), and 494 (55.9%) were 40-59 (mean 51) yr of age; the proportion receiving expanded criteria donor (ECD) kidneys were 66%, 49%, and 30%, respectively (p < 0.001). Mean waiting time (15 months) was shorter for pts ≥70 yr compared to the other two groups combined (23 months, p = 0.002). With mean follow-up ranging from 54 to 70 months, actual pt (81% vs. 72%, p = 0.002) and graft (66% vs. 58.5%, p = 0.03) survival rates were higher in the younger compared to the two older groups, whereas death-censored graft survival was similar (76% vs. 73%, p = NS). The incidence of death with a functioning graft correlated with older recipient age group, increasing from 13% to 18% to 23% (p = 0.01). The incidence of delayed graft function was similar (31.8% overall), and renal function, morbidity, and resource utilization were similar among groups.
  
  
  CONCLUSIONS
  By directing ECD kidneys to selected older pts, waiting times are reduced and censored survival outcomes are similar to middle-aged patients, suggesting that matching strategies for graft and patient lifespan are warranted.
authors.affiliation: Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Al-Shraideh
authors.forename: Umar
authors.initials: U
authors.lastname: Farooq
authors.forename: Alan C
authors.initials: AC
authors.lastname: Farney
authors.forename: Amudha
authors.initials: A
authors.lastname: Palanisamy
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rogers
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Orlando
authors.forename: Michael R
authors.initials: MR
authors.lastname: Buckley
authors.forename: Amber
authors.initials: A
authors.lastname: Reeves-Daniel
authors.forename: William
authors.initials: W
authors.lastname: Doares
authors.forename: Scott
authors.initials: S
authors.lastname: Kaczmorski
authors.forename: Michael D
authors.initials: MD
authors.lastname: Gautreaux
authors.forename: Samy S
authors.initials: SS
authors.lastname: Iskandar
authors.forename: Gloria
authors.initials: G
authors.lastname: Hairston
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Brim
authors.forename: Margaret
authors.initials: M
authors.lastname: Mangus
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stratta
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000592:standards*; D066027:Transplant Recipients; D055815:Young Adult
keywords: age matching; death with a functioning graft; deceased donors; delayed graft function; expanded criteria donor; kidney transplant; recipient age