Kidney Transplant From Elderly Donors: A Center Experience.

BACKGROUND

Renal transplantation is the treatment of choice in end-stage renal disease. With the aging of the population and better medical care available, the number of high-risk patients in terms of age and comorbidities on transplant waiting lists is increasing. Due to severe organ shortage, the use of expanded criteria and elderly donors is also increasing. We will review the outcomes of graft function and survival from a series of transplants from elderly deceased donors and compare the characteristics of the organs from donors older and younger than 70 years.

METHODS

We collected data from our transplant unit from 1993 until May 2019 and considered 2 groups of donors: donors A (aged ≥70 years) and donors B (aged <70 years).

RESULTS

The donors A group had more comorbidities with consequently higher Kidney Donor Profile Index scores than the donors B group, although there was no statistical difference regarding pre-donation serum creatinine level. Among transplant recipients, we also considered 2 groups, according to the age of the organ received: recipients A and recipients B. No difference was found between groups regarding the number of HLA mismatches, incidence of delayed graft function, number of hospitalizations, or incidence of acute rejection. Recipients' age, cold ischemia time, and graft function 1 year after transplant were worse in the recipients A group.

CONCLUSIONS

Although kidney graft function was worse in recipients from elderly donors, this difference had no clinical relevance, showing a possible benefit in patient survival compared with permanence in dialysis, so this type of transplant could be considered for older recipients.