Hypertension and donor age in living-related kidney transplantation

Post-transplantational hypertension is one of the most important factors which has negative influence on survival of a graft and a patient. The objective of this study was to evaluate the influence of donor's age on hypertension and the outcome in living-related transplantation of the kidney.

The research included 52 recipients of the graft, 30 women and 22 men who received living-related kidney graft in 5 years period. In experimental group there were recipients of grafts who's donors were 55 and older, and in control group recipients of graft who's donors were younger than 55. Age and sex of the donor, glomerular filtration rate of the donated kidney, previous dialysis treatment, kidney disease and number of months after transplantation were monitored. Blood pressure was measured once a day and average monthly value was assessed. Creatinine clearance was valuated once in six months. Functional kidney graft after 60 months was considered the one with serum creatinine < or = 150 micromol/l. Statistical analysis included t-test, Fisher's exact test, chi-square test, Kaplan- Meier curve and multivariant logistic regresion.

Experimental group included 23 examinees who received grafts from donors 55 years old and above (18 men and 5 women, average age 34.86 +/- 6.54, who have been treated for 35.33 +/- 37.59 months), and control group of 29 examinees from donors younger than 55 (16 men and 13 women, average age 31.69 +/- 10.5, who have been treated for 21.03 +/- 25.59 months). Average age of the donors in experimental group was 62.43 +/- 4.10 and 45.31 +/- 5.24 in control group. Mean creatinine clearance of the donated kidneys was 47.87+/- 10.5 ml/min in experimental group and 51.19 +/- 10.1 ml/min in the control (p = 0.005). Sixty months after transplantation graft was functional in 32.69% recipients of the experimental group and in 82.75% recipients of the control group. The average systolic blood pressure in experimental group was 146 +/- 20.00 mmHg, and in the control group 129 +/- 16.00 mmHg (p < 0.001). Average diastolic blood pressure was 90 +/- 11.00 mmHg in experimental group, and 83 +/- 10.00 mmHg in the control (p < 0.03).

Donor age has significant influence on long-term survival of the kidney graft in the living-related transplantation. Survival of the graft in examinees without hypertension is significantly longer. Treatment of post-transplatational hypertension is one of the most important tasks in the treatment of patients with transplanted kidney.