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Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
Published on: July 15, 2015
Kidneys from elderly deceased donors discarded for transplantation
A Andrés1, N Polanco, M P Cebrian
1Coordinación de Trasplantes and Servicios de Nefrologia and Urologia, Hospital 12 de Octubre, Madrid, Spain.
Transplantation Proceedings
|September 1, 2009
Summary
Kidneys from deceased donors over 60 years old are often discarded due to lack of suitable recipients or organ quality. However, these aged kidneys show good transplant survival rates in elderly patients, suggesting expanded criteria are warranted.
Area of Science:
- Nephrology
- Transplantation immunology
- Geriatric medicine
Background:
- Increasing number of deceased donors older than 60 years (D > 60).
- Limited data on kidney discard rates from aged donors.
- Established practice of transplanting D > 60 kidneys to elderly recipients.
Purpose of the Study:
- Analyze discard reasons for kidneys from D > 60.
- Compare discard rates and outcomes of D > 60 versus younger donors (D < 60).
- Evaluate the viability of D > 60 kidneys for elderly recipients.
Main Methods:
- Retrospective analysis of renal offers and transplants between 1997-2005.
- Categorization of discarded kidneys by donor age and reason for discard.
- Assessment of macroscopic and microscopic alterations.
- Comparison of graft survival rates between D > 60 and D < 60 groups.
Main Results:
- 57% of renal offers were from D > 60.
- 1145 D > 60 offers were discarded (inadequate donor or no recipient).
- 46% of D > 60 kidneys were discarded due to alterations vs. 14.7% for D < 60 (P < .01).
- Three-year graft survival was 83% for D > 60 vs. 89% for D < 60 (not significant).
Conclusions:
- Primary discard reasons for D > 60 kidneys: lack of elderly recipients and organ alterations.
- Transplantation of D > 60 kidneys in elderly recipients yields favorable outcomes.
- Expand kidney transplant eligibility to include more elderly dialysis patients.
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