title: Donation after Circulatory Death Renal Allografts--Does Donor Age Greater than 50 Years Affect Recipient Outcomes?
abstract: OBJECTIVE
  Donation after circulatory death renal allografts are associated with excellent outcomes. We performed a retrospective chart review to investigate the impact of donor age on postoperative and intermediate term outcomes.
  
  
  METHODS
  We compared recipient outcomes of donation after circulatory death allografts from donors older vs younger than 50 years. A total of 118 single donations after circulatory death renal transplants were performed at our institution between July 2006 and September 2013. Outcome variables (creatinine clearance, readmission rate, length of hospital stay, delayed graft function, graft loss and rejection) were compared between the 2 age categories using the Student t-test and the Pearson chi-square test. Independent prognosticators of creatinine clearance at 12 months were assessed with multivariate linear regression modeling.
  
  
  RESULTS
  Mean ± SD recipient age was 53.8 ± 14.7 years and 45.8% of donation after circulatory death donors were older than 50 years. Median followup was 21 months (range 1 to 87). Recipients of kidney transplants from donation after circulatory death donors older than 50 years demonstrated lower creatinine clearance at 1 month (mean 50.3 ± 25.3 vs 72.7 ± 31.7 ml per minute, p <0.001), 3 months (62.5 ± 22.9 vs 87.9 ± 36.4, p <0.001) and 1 year (66.2 ± 26.8 vs 87.8 ± 38.7, p = 0.013). However, the 2 groups did not differ with regard to delayed graft function, graft loss, hospital readmissions or length of hospital stay. Multivariate linear regression demonstrated that donor age, recipient age, recipient gender and cold ischemia time were independent predictors of creatinine clearance at 12 months.
  
  
  CONCLUSIONS
  Recipients of allografts from donors older than 50 years showed inferior renal function at 1 year but the 2 groups had similar graft survival and short-term outcomes. Longer followup is required to determine long-term allograft survival.
authors.affiliation: Division of Urology, Department of Surgery, Western University and Multi-Organ Transplant Program, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Huynh
authors.affiliation: Division of Urology, Department of Surgery, Western University and Multi-Organ Transplant Program, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Philippe D
authors.initials: PD
authors.lastname: Violette
authors.affiliation: Division of Urology, Department of Surgery, Western University and Multi-Organ Transplant Program, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Neal E
authors.initials: NE
authors.lastname: Rowe
authors.affiliation: Division of Urology, Department of Surgery, Western University and Multi-Organ Transplant Program, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Corinne
authors.initials: C
authors.lastname: Weernink
authors.affiliation: Division of Urology, Department of Surgery, Western University and Multi-Organ Transplant Program, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: MacLean
authors.affiliation: Division of Urology, Department of Surgery, Western University and Multi-Organ Transplant Program, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Alp
authors.initials: A
authors.lastname: Sener
authors.affiliation: Division of Urology, Department of Surgery, Western University and Multi-Organ Transplant Program, London Health Sciences Centre, London, Ontario, Canada. Electronic address: Patrick.Luke@lhsc.on.ca.
authors.forename: Patrick P
authors.initials: PP
authors.lastname: Luke
mesh_terms: D000367:Age Factors; D064591:Allografts; D003643:Death; D051799:Delayed Graft Function; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome
keywords: age factors; allografts; kidney transplantation; outcome and process assessment (health care); tissue donors