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Renal transplantation with aged donors
T Nakatani1, T Kim, Y Takemoto
1Department of Urology, Osaka City University Medical School, Osaka, Japan. nakatani@msic.med.osaka-cu.ac.jp
Insights
Kidney transplants from older cadaveric donors, specifically non-heart-beating (NHB) donors, are associated with poorer renal function and lower graft survival rates compared to younger donors.
Area of Science:
- Nephrology
- Transplantation Immunology
- Geriatric Medicine
Background:
- Cadaveric kidney transplantation is a vital treatment for end-stage renal disease.
- The impact of donor age on outcomes of non-heart-beating (NHB) cadaveric renal transplantation remains unclear.
- Previous research suggests aged heart-beating donors increase risks in kidney transplantation.
Purpose of the Study:
- To investigate the influence of donor age on the outcomes of non-heart-beating (NHB) cadaveric renal transplantation.
- To compare renal function and graft survival rates between younger and aged donor groups.
Main Methods:
- A retrospective analysis of 63 patients who received cadaveric renal transplantation between July 1986 and May 1999.
- Patients were divided into two groups based on donor age: younger and aged donors.
- Comparison of nadir donor serum creatinine, immediate graft function, and graft survival rates.
Main Results:
- Aged donor group showed significantly worse mean nadir donor serum creatinine (P < 0.05).
- The aged donor group had a lower percentage of immediately functioning grafts and a higher percentage of non-functioning grafts.
- Graft survival rates were significantly lower in the aged donor group during the first 10 years post-transplant.
Conclusions:
- Cadaveric renal transplantation from NHB aged donors negatively impacts renal function and graft survival.
- Younger donors are associated with better outcomes in NHB cadaveric renal transplantation.
- Donor age is a critical factor to consider in NHB cadaveric kidney transplantation strategies.
Abstract:
Research indicates that aged heart-beating cadaveric donors cause greater risk factors in kidney transplantation. The influence of age on the outcome of non-heart-beating (NHB) cadaveric renal transplantations has not yet been clarified. From July 1986 to May 1999, 63 patients who received cadaveric renal transplantation at Osaka City University Hospital and Osaka City General Hospital were divided into two groups according to their age. Renal function and graft-survival rates of the two groups were compared. The mean values of nadir donor serum creatinine were significantly worse (P < 0.05) in the aged donor group. In the aged donor group the percentage of immediately functioning grafts was lower and the percentage of non-functioning grafts was higher. During the first 10 years post-transplant, graft survival in the aged donor group was significantly lower than that in the younger donor group. We conclude that cadaveric renal transplantation from NHB aged donors can be to the detriment of renal function and graft survival rates compared to transplantation from younger donors.