Kidney transplantation from elderly donors: single-center experience

  • Ramazan Kozan Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
  • Ali Sapmaz Department of General Surgery, Bilkent City Hospital, Ankara, Turkey
  • Hakan Sözen Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
  • Aydın Dalgıç Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
Keywords: elderly donors, kidney transplantation, outcome

Abstract

Introduction: The shortage of deceased donor kidneys for transplantation has forced the re-evaluation 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). Twenty-one (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

1) Dols LF, Kok NF, Roodnat JI, Tran TC, Terkivatan T, Zuidema WC, et al. Living kidney donors: impact of age on long-term safety. Am J Transplant. 2011;11(4):737-42. doi: 10.1111/j.1600-6143.2011.03465.x.

2) Alexander JW, Bennett LE, Breen TJ. Effect of donor age on outcome of kidney transplantation. A two-year analysis of transplants reported to the United Network for Organ Sharing Registry. Transplantation. 1994;57(6):871-6.

3) Cosio FG, Henry M, Pesavento TE, Ferguson RM, Kim S, Lemeshow S. The relationship between donor age and cadaveric renal allograft survival is modified by the recipient's blood pressure. Am J Transplant. 2003;3(3):340-7. doi: 10.1034/j.1600-6143.2003.00064.x.

4) Dickenmann MJ, Nickeleit V, Tsinalis D, Gürke L, Mihatsch MJ, Thiel G. Why do kidney grafts fail? A long-term single-center experience. Transpl Int. 2002;15(9-10):508-14. doi: 10.1111/j.1432-2277.2002.tb00207.x.

5) Moreso F, Serón D, Gil-Vernet S, Riera L, Fulladosa X, Ramos R, et al. Donor age and delayed graft function as predictors of renal allograft survival in rejection-free patients. Nephrol Dial Transplant. 1999;14(4):930-5. doi: 10.1093/ndt/14.4.930.

6) Humar A, Ramcharan T, Kandaswamy R, Gillingham K, Payne WD, Matas AJ. Risk factors for slow graft function after kidney transplants: a multivariate analysis. Clin Transplant. 2002;16(6):425-9. doi: 10.1034/j.1399-0012.2002.02055.x.

7) Sözen H, Fidan K, Onaran M, Arinsoy T, Dalgiç A. Outcome of the using older donors for kidney transplantation; Gazi University, Ankara experience. Transplant Proc. 2010;42(7):2477-8. doi: 10.1016/j.transproceed.2010.04.044.

8) Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in 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.

9) Jain S, Saltzman B, Miller A, Ortiz J, Nofziger J. Same-day discharge for laparoscopic donor nephrectomy. JSLS. 2017;21(2):e2017.00019. doi: 10.4293/JSLS.2017.00019.

10) Laging M, Kal-van Gestel JA, van de Wetering J, Ijzermans JN, Weimar W, Roodnat JI. The relative importance of donor age in deceased and living donor kidney transplantation. Transpl Int. 2012;25(11):1150-7. doi: 10.1111/j.1432-2277.2012.01539.x.

11) Denic A, Glassock RJ, Rule AD. Structural and functional changes with the aging kidney. Adv Chronic Kidney Dis. 2016;23(1):19-28. doi: 10.1053/j.ackd.2015.08.004.

12) Matas AJ, Gillingham KJ, Humar A, Dunn DL, Sutherland DE, Najarian JS. Immunologic and nonimmunologic factors: different risks for cadaver and living donor transplantation. Transplantation. 2000;69(1):54-8. doi: 10.1097/00007890-200001150-00011.

13) Gill J, Bunnapradist S, Danovitch GM, Gjertson D, Gill JS, Cecka M. Outcomes of kidney transplantation from older living donors to older recipients. Am J Kidney Dis. 2008;52(3):541-52. doi: 10.1053/j.ajkd.2008.05.017.

14) Nikodimopoulou M, Karakasi K, Daoudaki M, Fouza A, Vagiotas L, Myserlis G, et al. Kidney transplantation in old recipients from old donors: a single-center experience. Transplant Proc. 2019;51(2):405-7. doi: 10.1016/j.transproceed.2019.01.019.

15) Gallinat A, Paul A, Treckmann JW, Molmenti EP, Dittmann S, Hoyer DP, et al. Single-center experience with live kidney donors 60 years of age or older. Am Surg. 2014c;80(12):1230-6.

16) Oppenheimer F, Aljama P, Asensio Peinado C, Bustamante Bustamante J, Crespo Albiach JF, Guirado Perich L. The impact of donor age on the results of renal transplantation. Nephrol Dial Transplant. 2004;19(Suppl 3):iii11-5. doi: 10.1093/ndt/gfh1008.

17) Liem YS, Wong JB, Hunink MG, de Charro FT, Winkelmayer WC. Comparison of hemodialysis and peritoneal dialysis survival in The Netherlands. Kidney Int. 2007;71(2):153-8. doi: 10.1038/sj.ki.5002014.

18) Saran R, Robinson B, Abbott KC, Bragg-Gresham J, Chen X, Gipson D, et al. US Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2020;75(1 Suppl 1):A6-A7. doi: 10.1053/j.ajkd.2019.09.003.

19) Boom H, Mallat MJ, de Fijter JW, Zwinderman AH, Paul LC. Delayed graft function influences renal function, but not survival. Kidney Int. 2000;58(2):859-66. doi: 10.1046/j.1523-1755.2000.00235.x.

20) Helfer MS, Pompeo JC, Costa ORS, Vicari AR, Ribeiro AR, Manfro RC. Long-term effects of delayed graft function duration on function and survival of deceased donor kidney transplants. J Bras Nefrol. 2019;41(2):231-41. doi: 10.1590/2175-8239-jbn-2018-0065.
Published
2022-03-15
How to Cite
1.
Kozan R, Sapmaz A, Sözen H, Dalgıç A. Kidney transplantation from elderly donors: single-center experience. Rev Nefrol Dial Traspl. [Internet]. 2022Mar.15 [cited 2024Dec.25];42(1):41-7. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/755
Section
Original Article