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April 1, 2004

Renal Transplant Survival From Older Donors: A Single Center Experience

Arch Surg. 2004;139(4):384-389. doi:10.1001/archsurg.139.4.384

Hypothesis  Despite the observation that kidney transplantations from older donors have an increased risk of failure, the percentage of kidney donors 55 years and older has increased. We explored the risk of allograft failure in a single transplantation center with older (55-79 years) vs younger (18-54 years) donors.

Design  Retrospective cohort review with a mean follow-up of 32 months.

Setting  Academic transplant center.

Patients  Consecutive recipients (n = 324) of renal transplants from adult donors.

Interventions  Patients were divided into 4 groups based on donor status (living or deceased) and donor age (≤54 or ≥55 years).

Main Outcome Measures  Allograft survival and function, incidence of acute rejection.

Results  Recipients of older donor kidneys were significantly older (53.6 vs 43.6 years, P<.001). Seven allografts (12.7%) failed from 55 transplants from donors 55 years and older, compared with 41 allografts (15.2%) from 269 younger donors (P = .63). Renal function was superior following renal transplantation using younger donors (P = .004). However, renal function was acceptable in all groups, with a mean ± SD serum creatinine level of 1.7 ± 0.4 mg/dL (150 ± 35 µmol/L) among recipients of older donor kidneys. Allograft survival at 1, 2, and 3 years, censored for death with allograft function, did not differ when comparing older vs younger donors.

Conclusions  Most patients receiving allografts from older donors do well. Older donor kidneys provide suitable renal function for many patients on dialysis awaiting transplantation.