Renal transplant survival from older donors: a single center experience.

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 (< or =54 or > 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 micro mol/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.