Kidney transplantation using donors over 70 years old: are the criteria for organ allocation too expanded?

The scarcity of organs available for transplantation has led to the use of kidneys from old deceased donors including those ≥70 years of age. The results of kidney transplants performed using such "limit" organs warrent further study.

We retrospectively evaluated all cadaveric heart-beating renal transplants performed from September 1996 to June 2010 using expanded-criteria donors: Group 1 included 302 transplants performed with kidneys from expanded-criteria donors aged 50-69 years; group 2 included 60 recipients of kidneys from donors aged ≥70 years. All patients were prescribed an immunossupressive regimen based on mycophenolate mofetil or mycophenolic acid, a calcineurin inhibitor, and corticosteroids, with or without monoclonal/polyclonal antibodies.

The baseline recipient characteristics were similar except for age, which was higher in group 2; history of previous transplantation was absent in group 2, and there was more use of induction with monoclonal or polyclonal antibodies in group 2 (65% vs 49%; P = .02). There was no significant difference in the rate of nonfunctioning grafts, delayed graft function, or acute rejection episodes in the first 6 months. There was no significant difference between groups regarding graft or patient survival.

The use of kidneys from donors aged ≥70 older than or years yielded generally satisfactory results.