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Updated: Jun 14, 2026
Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
Published on: July 15, 2015
Why not to use kidney grafts from elderly donors
M F Cassini1, A J Cologna, S Tucci
1Division of Urology, Department of Surgery and Anatomy, Ribeiro Preto Medical School, University of São Paulo, São Paulo, Brazil. marcelo.cassini@globo.com
Background:
Kidney transplantation is widely recognized as the best treatment in patients who require renal replacement therapy. Although considered a clinical and surgical triumph, it is also a source of frustration because of lack of donor organs and the growth of waiting lists. Strategies need to be developed to increase the supply of organs. One measure is use of expanded criteria for donation.
Objective:
To evaluate the effect of donor age on cadaver graft survival.
Materials And Methods:
We reviewed the medical records for 454 patients who underwent kidney transplantation with cadaver donors from April 1987 to December 2003.
Results:
Donor age had a significant effect on kidney transplant survival. Survival of grafts from donors aged 16 to 40 years (mean, 143.30 months) was significantly greater compared with that of grafts from donors older than 40 years (66.46 months) (P = .005). The HLA matching and cold ischemia time did not significantly affect transplant survival (P = .98 and P = .16, respectively).
Conclusions:
Kidneys from cadaver donors older than 40 years significantly compromised graft survival, generating a negative effect via early return of recipients to waiting lists and increasing the rate of repeat transplantation, risk of death, and unnecessary costs.
Insights
Donor age significantly impacts kidney transplant success. Kidneys from donors over 40 years old result in shorter graft survival, increasing repeat transplants and mortality risks.
Area of Science:
- Nephrology
- Transplantation immunology
Background:
- Kidney transplantation is the optimal renal replacement therapy.
- Organ shortages and long waiting lists necessitate strategies to increase donor organ supply.
- Utilizing expanded donor criteria is one such strategy.
Purpose of the Study:
- To assess the influence of donor age on cadaver kidney graft survival.
Main Methods:
- Retrospective review of medical records for 454 kidney transplant recipients.
- Data collected from April 1987 to December 2003.
- Analysis focused on donor age, HLA matching, and cold ischemia time.
Main Results:
- Donor age significantly affected kidney transplant survival (P = .005).
- Grafts from donors aged 16-40 years had longer mean survival (143.30 months) compared to those from donors >40 years (66.46 months).
- HLA matching and cold ischemia time did not significantly impact survival.
Conclusions:
- Cadaver kidney donors older than 40 years are associated with significantly reduced graft survival.
- This negatively impacts recipients by increasing waiting list returns, repeat transplants, mortality, and healthcare costs.
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