2022, Number 1
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Rev Nefrol Dial Traspl 2022; 42 (1)
Kidney transplantation from elderly donors: single-center experience
Kozan R, Sapmaz A, SOzen H, Dalgıç A
Language: English
References: 20
Page: 41-47
PDF size: 243.74 Kb.
ABSTRACT
Introduction: The shortage
of deceased donor kidneys for
transplantation has forced the reevaluation
of the limits on donor age
acceptability. Thus, marginal donors
such as elderly donors have been
progressively increasing in recent years
for organ transplantation around the
world.
Aim: In this study, it was aimed
to contribute to the elimination of
question marks about the using elderly
donors for kidney transplantation.
Methods: In this retrospective cohort
study, prospectively recorded data
of patients who underwent kidney
transplantation between January 1996
and January 2020 were evaluated.
The inclusion criteria for the study
were deceased or living donor, donor
aged 55 years and older.
Results: Of
the total 392 kidney transplantation,
64 donors met the study criteria.
The mean age of the donors was 59
± 3.86 years (range, 55-69). Twentyone
(87.5%) out of 24 deceased
donors and 1 (2.5%) living related
recipients presented DGF. There was
no mortality in the living donors.
Overall, 1, 5, 10 years of recipient
and graft survivals for this study
91%, 88%, 81% and 84%, 82%,
75%, respectively. Same rates for
living donor 96%, 96%, 96% and
90%, 88%, 80%, respectively, and
for deceased donor 81%, 74%, 70%
and 78%, 74%, 67%, respectively.
Conclusion: Transplantation from the
donors with age 55 and up, might be
related to decreased kidney function
and graft survival, compared to the
transplantations from the standard
donors. However, when the long-term
graft survival and patient survival is
observed, the group of elderly donors
cannot be subject to exclusion.
REFERENCES
Dols LF, Kok NF, Roodnat JI, Tran TC, Terkivatan T,Zuidema WC, et al. Living kidney donors: impact of ageon long-term safety. Am J Transplant. 2011;11(4):737-42. doi: 10.1111/j.1600-6143.2011.03465.x.
Alexander JW, Bennett LE, Breen TJ. Effect of donorage on outcome of kidney transplantation. A twoyearanalysis of transplants reported to the UnitedNetwork for Organ Sharing Registry. Transplantation.1994;57(6):871-6.
Cosio FG, Henry M, Pesavento TE, Ferguson RM,Kim S, Lemeshow S. The relationship betweendonor age and cadaveric renal allograft survival ismodified by the recipient’s blood pressure. Am JTransplant. 2003;3(3):340-7. doi: 10.1034/j.1600-6143.2003.00064.x.
Dickenmann MJ, Nickeleit V, Tsinalis D, GürkeL, Mihatsch MJ, Thiel G. Why do kidney graftsfail? A long-term single-center experience. TransplInt. 2002;15(9-10):508-14. doi: 10.1111/j.1432-2277.2002.tb00207.x.
Moreso F, Serón D, Gil-Vernet S, Riera L, Fulladosa X,Ramos R, et al. Donor age and delayed graft functionas predictors of renal allograft survival in rejection-freepatients. Nephrol Dial Transplant. 1999;14(4):930-5.doi: 10.1093/ndt/14.4.930.
Humar A, Ramcharan T, Kandaswamy R, Gillingham K,Payne WD, Matas AJ. Risk factors for slow graft functionafter kidney transplants: a multivariate analysis. ClinTransplant. 2002;16(6):425-9. doi: 10.1034/j.1399-0012.2002.02055.x.
Sözen H, Fidan K, Onaran M, Arinsoy T, DalgiçA. Outcome of the using older donors for kidneytransplantation; Gazi University, Ankara experience.Transplant Proc. 2010;42(7):2477-8. doi: 10.1016/j.transproceed.2010.04.044.
Dindo D, Demartines N, Clavien PA. Classification ofsurgical complications: a new proposal with evaluationin a cohort of 6336 patients and results of a survey.Ann Surg. 2004;240(2):205-13. doi: 10.1097/01.sla.0000133083.54934.ae.
Jain S, Saltzman B, Miller A, Ortiz J, Nofziger J. Samedaydischarge for laparoscopic donor nephrectomy.JSLS. 2017;21(2):e2017.00019. doi: 10.4293/JSLS.2017.00019.
Laging M, Kal-van Gestel JA, van de Wetering J,Ijzermans JN, Weimar W, Roodnat JI. The relativeimportance of donor age in deceased and living donorkidney transplantation. Transpl Int. 2012;25(11):1150-7. doi: 10.1111/j.1432-2277.2012.01539.x.
Denic A, Glassock RJ, Rule AD. Structural andfunctional changes with the aging kidney. Adv ChronicKidney Dis. 2016;23(1):19-28. doi: 10.1053/j.ackd.2015.08.004.
Matas AJ, Gillingham KJ, Humar A, Dunn DL,Sutherland DE, Najarian JS. Immunologic andnonimmunologic factors: different risks for cadaverand living donor transplantation. Transplantation.2000;69(1):54-8. doi: 10.1097/00007890-200001150-00011.
Gill J, Bunnapradist S, Danovitch GM, Gjertson D, GillJS, Cecka M. Outcomes of kidney transplantation fromolder living donors to older recipients. Am J Kidney Dis.2008;52(3):541-52. doi: 10.1053/j.ajkd.2008.05.017.
Nikodimopoulou M, Karakasi K, Daoudaki M, FouzaA, Vagiotas L, Myserlis G, et al. Kidney transplantationin old recipients from old donors: a single-centerexperience. Transplant Proc. 2019;51(2):405-7. doi:10.1016/j.transproceed.2019.01.019.
Gallinat A, Paul A, Treckmann JW, Molmenti EP,Dittmann S, Hoyer DP, et al. Single-center experiencewith live kidney donors 60 years of age or older. AmSurg. 2014c;80(12):1230-6.
Oppenheimer F, Aljama P, Asensio Peinado C,Bustamante Bustamante J, Crespo Albiach JF, GuiradoPerich L. The impact of donor age on the results of renaltransplantation. Nephrol Dial Transplant. 2004;19(Suppl3):iii11-5. doi: 10.1093/ndt/gfh1008.
Liem YS, Wong JB, Hunink MG, de Charro FT,Winkelmayer WC. Comparison of hemodialysis andperitoneal dialysis survival in The Netherlands. KidneyInt. 2007;71(2):153-8. doi: 10.1038/sj.ki.5002014.
Saran R, Robinson B, Abbott KC, Bragg-Gresham J,Chen X, Gipson D, et al. US Renal Data System 2019Annual Data Report: Epidemiology of Kidney Diseasein the United States. Am J Kidney Dis. 2020;75(1 Suppl1):A6-A7. doi: 10.1053/j.ajkd.2019.09.003.
Boom H, Mallat MJ, de Fijter JW, ZwindermanAH, Paul LC. Delayed graft function influences renalfunction, but not survival. Kidney Int. 2000;58(2):859-66. doi: 10.1046/j.1523-1755.2000.00235.x.
Helfer MS, Pompeo JC, Costa ORS, Vicari AR, RibeiroAR, Manfro RC. Long-term effects of delayed graftfunction duration on function and survival of deceaseddonor kidney transplants. J Bras Nefrol. 2019;41(2):231-41. doi: 10.1590/2175-8239-jbn-2018-0065.