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Updated: Aug 9, 2026
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Heterotopic Renal Autotransplantation in a Porcine Model: A Step-by-Step Protocol
Published on: February 21, 2016
Kidney transplantation using elderly non-heart-beating donors: a single-center experience
M G J Snoeijs1, S Schaefer, M H Christiaans
1Department of Surgery, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), University Hospital Maastricht and Maastricht University. The Netherlands.
Summary
Utilizing elderly non-heart-beating (NHB) donors for kidney transplants showed poorer outcomes. Careful donor selection, possibly with biopsies, is needed to improve results from this expanded donor pool.
Area of Science:
- Nephrology
- Transplantation immunology
- Geriatric medicine
Background:
- Non-heart-beating (NHB) donors and elderly donors are individually accepted sources for kidney transplantation.
- The combined pool of elderly NHB donors remains underutilized.
- Expanding donor criteria is crucial to meet organ demand.
Purpose of the Study:
- To compare clinical outcomes of kidney transplants from elderly NHB donors (≥65 years) versus conventional NHB donors.
- To evaluate the feasibility of utilizing older NHB donors to increase the kidney donor pool.
- To identify factors influencing graft survival in elderly NHB donor kidney transplantation.
Main Methods:
- Retrospective analysis of kidney transplant recipients between 1994 and 2005.
- Comparison of outcomes between two groups: elderly NHB donors (≥65 years) and younger NHB donors (<65 years).
- Assessment of graft survival and glomerular filtration rates (GFR) at 1 and 5 years post-transplantation.
Main Results:
- Kidneys from elderly NHB donors had significantly lower 1-year GFR (29 vs. 44 mL/min, p=0.01).
- 5-year graft survival was lower in the elderly NHB donor group (52% vs. 68%), though not statistically significant (p=0.19).
- Excluding older NHB donor kidneys with severe vascular pathology led to comparable graft survival rates between older and younger NHB donor groups.
Conclusions:
- The use of elderly NHB donors, without refined selection criteria, is associated with unacceptable clinical outcomes.
- Histological assessment of pretransplant biopsies may be necessary for better selection of elderly NHB donors.
- Further research is needed to optimize the utilization of elderly NHB donors in kidney transplantation.
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