Kidney Transplant From Elderly Donors: A Center Experience

Area of Science:

• Nephrology
• Transplantation immunology
• Geriatric medicine

Background:

• Renal transplantation is the preferred treatment for end-stage renal disease.
• Increasing patient age and comorbidities raise the number of high-risk individuals on transplant waiting lists.
• Organ shortages necessitate the use of expanded criteria and elderly donors.

Purpose of the Study:

• To review graft function and survival outcomes from elderly deceased donor kidney transplants.
• To compare organ characteristics from donors aged ≥70 years versus <70 years.

Main Methods:

• Data collected from a transplant unit between 1993 and May 2019.
• Donors categorized into two groups: ≥70 years (Group A) and <70 years (Group B).
• Transplant recipients also grouped based on donor age (Recipients A and B).

Main Results:

• Donors ≥70 years had more comorbidities and higher Kidney Donor Profile Index scores.
• No significant difference in pre-donation serum creatinine levels between donor groups.
• Recipients of organs from donors ≥70 years experienced worse graft function, longer cold ischemia times, and older recipient age, but no differences in HLA mismatches, delayed graft function, hospitalizations, or acute rejection.

Conclusions:

• While kidney graft function is reduced with elderly donors, the clinical impact is minimal.
• Transplantation using elderly donors may offer survival advantages compared to remaining on dialysis.
• Consideration of elderly donors for older recipients is a viable strategy to improve patient survival.