Elderly donor kidney grafts into young recipients: results at 5 years

To date, few data are available on older donor renal grafts transplanted into young recipients. We compare 63 kidneys grafts from donors older than 60 years transplanted into recipients younger than 60 years (group 1) with a control group of 235 patients in whom both recipients and donors were younger than 60 years (group 2).

Patient survival rates at 1 and 5 years, respectively, were 98% and 95% (group 1) and 95% and 84% (group 2) (P=0.01). Graft survival rates were 95% and 83% in group 1 versus 94% and 81% in group 2, although death censoring was significant (100% and 98% group 1 vs. 96% and 86% group 2, P=0.04). In group 1, plasmatic creatinemia was significantly higher. The aged donor, female donor-male recipient combination, and the presence of acute rejection alone or together with acute tubular necrosis, were determinants for worse renal functioning at 1 year after transplantation. Seven patients had chronic nephropathy not related to any clinical parameter.

We conclude that kidneys from older donors can be successfully transplanted to younger patients.