Abstract
The lack of available cadaveric organs for transplantation has resulted in an increased number of kidney transplants from living donors. During a period of 6 years, 149 kidney transplantations were performed from living related donors in our institute, 33.5% of whom were older than 60 years of age. In this study we examined the survival of patients and grafts as well as the graft function in 50 patients with transplants from donors over 60 years (mean age 65 years) as compared with those of 99 patients with transplants from donors younger than 60 years (mean age 47 years). There were no significant differences in the course of donor nephrectomy, postoperative complications, or remnant kidney function. However, delayed graft function occurred more frequently in recipients of transplants from older donors. Improvement in graft function was also slower in recipients of kidneys from older donors, with significant differences in serum creatinine levels observed during the first 12 months after transplantation. More frequent acute complications and more progressive chronic graft failure, irrespective of the causes, occurred during the 1st post-transplant year in recipients with grafts from older donors. Five-year patient survival (77% vs 92%) and kidney graft survival differed significantly for the same period with worse results for patients receiving grafts from older donors. It may be concluded that kidney grafts from donors older than 60 years — and especially those older than 70 years — may be used for living related kidney transplantation, but with precautions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Alexander JW, Vaughn WK (1991) The use of “marginal” donors for organ transplantation: the influence of donor on outcome. Transplantation 51:135–141
Anaise D, Rapaport FT (1993) Use of non heart beating cadaver donors in clinical organ transplantation—logistics, ethics, and legal considerations. Transplant Proc 25: 2153–2155
Aswad S, Cicciarelli J, Mendez R, Dessouki M (1992) Renal transplantation from a donor over 60 years old. Transplantation 53: 213–214
Campistol JM, Oppenheimer F, Ponz E (1990) Aged kidney donors. EDTA-ERA, Abstract no 198
Cecka JM, Terasaki PI (1995) Optimal use for older donor kidneys: older recipients. Transplant Proc 27: 801–802
Creagh TA, McLean PA, Donovan MG, Walshe JJ, Murphy DM (1993) Older donors and kidney transplantation. Transpl Int 6: 39–41
Donnelly PK, Henderson R (1990) Matching for age in renal transplantation. N Engl J Med 322: 851–852
Elgueta S, Fuentes C, Santamaria L, Wegmann ME, Melendez M, and Chilean Renal Transplant Centers (1992) Effects of recipients and donor relationships and sex on graft surfival in living-related renal transplantation. Transplant Proc 24: 3074–3075
Evans R (1990) Organ donation: facts and figures. Dial Transplant 19: 234–240
Geerlings W, Tufveson G, Ehrich JHH, Jones EHP, Landais P, Loirat C, Mallick NP, Margreiter R, Raine AEG, Salmela K, Selwood NH, Valderrabano F (1994) Report on management of renal failure in Europe. Nephrol Dial Transplant 23 [Suppl 1]: 6–25
Hardy B, Cicciarelli JC, Iwaki Y, Shaul D, Mendez R (1994) Effect of donor age on graft survival rates in pediatric living-related transplants, first cadaver transplants and regrafts. Transplant Proc 26: 44–45
Higgins RM, Sheriff R, Bittar AA, Richardson AJ, Ratcliffe PJ, Gray DWR, Morris PJ (1995) The quality of function of renal allografts is associated with donor age. Transpl Int 8:221–225
Iguro T, Okazaki H, Sato T, Jimbo M, Oguma S (1989) The effect of donor age and sex on cyclosporine associated nephrotoxicity. Transplant Proc 21: 1554–1555
Kaplan EL, Meier P (1958) Non parametric estimation from incomplete observations. J Am Stat Assoc 53: 457
Kostakis A, Sotirchos G, Stamatiadis D (1990) Outcome of renal transplantation from living related donors (LRD) aged more than 60 years. EDTA-ERA, Abstract no 211
Längle F, Sautner T, Grünberger T, Gölzinger P, Schuster G, Pohanka E, Steininger R, Mühlbacher F (1992) Impact of donor age on graft function in living-related kidney transplantation. Transplant Proc 24: 2725–2727
Lawless JE (1982) Statistical models and methods for life time data. Wiley, New York
Morgan T (1979) Physiologie renale. In: Hamburger J, Crossnier J, Grunfeld JP (eds) Nephrologie, vol 1. Flammarion, Paris, pp 57–98
Nathan HM, Jarrell BE, Broznik B (1991) Estimation and characterization of the potential renal organ donor pool in Pennsylvania statewide donors' study. Transplantation 51: 142–149
Nyberg G, Hedman L, Blohme I, Svalander C (1992) Morphologic findings in baseline kidney biopsies from living related donors. Transplant Proc 24: 355–356
Paul LC (1993) Chronic rejection of organ allografts: magnitude of the problem. Transplant Proc 25: 2024–2025
Phillips AO, Bewick M, Snowden SA, Hillis AN, Hendry BM (1993) The influence of recipient and donor age on the outcome of renal transplantation. Clin Nephrol 40: 352–354
Raine AEG, Margreiter R, Brunner FP, Ehrich JHH, Geelings W, Landais P, Loirat C, Mallick NP, Selwood NH, Tufveson G, Valderrabano F (1992) Report on management of renal failure in Europe, 1991. Nephrol Dial Transplant 22 [Suppl 2]: 7–35
Rosman J, Steinhauslin F, David S, Genton A, Mosimann F, Wauters JP (1992) Impact of recipient and donor age on the outcome of renal transplantation. Transplant Proc 24: 2723–2724
Rosner F (1990) Anencephalic infants as organ donors. N Engl J Med 322: 331–332
Solez K, Axelen RA, Benediktisson H, Burdick J, Cohen AH, Colvin RB, Croker BP, Droz D, Dunnill MS, Halloran PH, Hayry P, Jannette JC, Keown PA, Markussen N, Mihatsch MJ, Morozumi K, Myers BD, Nast CC, Olsen S, Racusen L, Ramos EL, Rosen S, Sachs DH, Salomon DR, Sanfilippo F, Verani R, Von Willebrand E, Yamaguchi Y (1993) Internal standardization of criteria for the histologic diagnosis of renal allograft rejection: the Banff working classification of kidney transplant pathology. Kidney Int 44: 411–422
Sugiyama S, Tsuyuki M, Okazaki Y, Takeuchi N, Matsuura O, Ohshima S (1994) Arteriosclerotic lesions of donor kidney and graft survival. Transplant Proc 26: 929–930
Sumrani N, Delaney V, Ding Z, Davis R, Daskalakis P, Tejani A, Butt K, Hong J (1991) Renal transplantation from elderly living donors. Transplantation 51: 305–309
Thorogood J, Persijn GG, Zantvoort FA, Houwelingen JC van, Rood JJ van (1990) Matching for age in renal transplantation. N Engl J Med 322: 852
Author information
Authors and Affiliations
About this article
Cite this article
Ležaić, V., Djukanović, L., Blagojević-Lazić, R. et al. Living related kidney donors over 60 years old. Transpl Int 9, 109–114 (1996). https://doi.org/10.1007/BF00336387
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00336387