Donation from old living donors: how safe is it?

Area of Science:

• Nephrology
• Transplantation Surgery
• Geriatrics

Background:

• Living kidney donor (LKD) transplantation is increasing.
• Extended criteria donors, including older individuals (>60-65 years), are increasingly utilized.
• A lower glomerular filtration rate (GFR) threshold may expand the pool of eligible older donors.

Purpose of the Study:

• To evaluate the safety and outcomes of kidney donation from older living donors.
• To compare the risks of death and end-stage renal disease (ESRD) in older donors versus matched controls.
• To assess the long-term renal function and cardiovascular risks in elderly kidney donors.

Main Methods:

• Review of recent large cohort studies on living kidney donors.
• Analysis of outcomes including mortality, ESRD, post-donation GFR, and cardiovascular risk.
• Comparison of old donors with younger donors and general population controls.

Main Results:

• The risk of death and ESRD in older donors is similar to matched controls.
• Older donors have lower post-donation GFR but similar rates of function loss compared to younger donors.
• Kidney transplantation from older living donors yields results comparable to deceased younger donor transplants.
• Older living donor transplantation is a safe procedure for both donor and recipient.

Conclusions:

• Age alone is not a contraindication for living kidney donation.
• Older living donors experience comparable long-term risks to the general population.
• Kidney transplantation using older living donors is a viable and safe option.