Kidney transplantation using donors over 70 years old: are the criteria for organ allocation too expanded?

Transplant Proc. 2012 Oct;44(8):2289-92. doi: 10.1016/j.transproceed.2012.07.031.

Abstract

Background: The scarcity of organs available for transplantation has led to the use of kidneys from old deceased donors including those ≥70 years of age. The results of kidney transplants performed using such "limit" organs warrent further study.

Methods: We retrospectively evaluated all cadaveric heart-beating renal transplants performed from September 1996 to June 2010 using expanded-criteria donors: Group 1 included 302 transplants performed with kidneys from expanded-criteria donors aged 50-69 years; group 2 included 60 recipients of kidneys from donors aged ≥70 years. All patients were prescribed an immunossupressive regimen based on mycophenolate mofetil or mycophenolic acid, a calcineurin inhibitor, and corticosteroids, with or without monoclonal/polyclonal antibodies.

Results: The baseline recipient characteristics were similar except for age, which was higher in group 2; history of previous transplantation was absent in group 2, and there was more use of induction with monoclonal or polyclonal antibodies in group 2 (65% vs 49%; P = .02). There was no significant difference in the rate of nonfunctioning grafts, delayed graft function, or acute rejection episodes in the first 6 months. There was no significant difference between groups regarding graft or patient survival.

Conclusions: The use of kidneys from donors aged ≥70 older than or years yielded generally satisfactory results.

MeSH terms

  • Acute Disease
  • Adult
  • Age Factors
  • Aged
  • Chi-Square Distribution
  • Delayed Graft Function / etiology
  • Donor Selection*
  • Female
  • Graft Rejection / immunology
  • Graft Survival
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kaplan-Meier Estimate
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / immunology
  • Kidney Transplantation* / mortality
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Tissue Donors / supply & distribution*
  • Tissue and Organ Procurement*
  • Treatment Outcome
  • Waiting Lists

Substances

  • Immunosuppressive Agents