Influence of cadaver donor age on renal graft survival

It has been suggested that kidneys from young and old donors do less well after transplantation. We have studied this problem in a retrospective analysis of all cadaveric transplants performed in our center during the last 10 years. All patients were followed for at least six months. Recipients younger than 16 years were excluded from this analysis. Thirty-six patients received a kidney from a donor younger than 11 years (group A), 374 received a kidney from a donor aged between 11 and 51 years (group B) and 21 a kidney from a donor aged older than 51 years (group C). In the young donor age group graft survival was significantly worse than in the two other groups with a one year graft survival of 45.6%, 75.0% and 75.9% for group A, B and C respectively. There were significantly more technical failures in group A, but if these were excluded a significant difference in graft survival remained present. At three months there were no significant differences in hypertension, proteinuria, or serum creatinine between the three groups. These results suggest that young but not old donor kidneys have a worse graft survival. This decreased graft survival is only partly caused by technical problems. Therefore young grafts also seem to be more susceptible to the host's immune response.