Outcome of Kidney Transplantation Using Organs From Brain-dead Donors Older Than 75 Years

Transplant Proc. 2020 Jan-Feb;52(1):119-126. doi: 10.1016/j.transproceed.2019.11.013. Epub 2019 Dec 31.

Abstract

Purpose: We investigated whether older donor kidneys aged >75 years have acceptable long-term function and if recipients can benefit sufficiently from the transplantation.

Methods: This single-center study retrospectively analyzed patient data from 217 deceased donor kidney transplants performed between 1998 and 2014 as part of the Eurotransplant Senior Program, where the organ donors were ≥65 years old. Depending on donor age, the groups "older donors" (OD; n = 161) and "very old donors" (VOD; n = 56) received transplants from donors aged 65 to 75 years and >75 years, respectively. Donor and recipient clinical characteristics, delayed graft function, estimated glomerular filtration rate, 1-year rejection rate, patient and graft survival, and postoperative complications were investigated.

Results: Comparing VOD group vs OD group, the 1-year, 3-year, and 5-year graft survival rates were 80.4% vs 76.4%, 62.5% vs 65.8%, and 42.6% vs 57.3%, respectively. Patient survival rates after 1, 3, and 5 years were 89.3% vs 88.2%, 71.4% vs 78.2%, and 57.5% vs 71.8%, respectively. There were no significant differences between the 2 groups (graft survival P = .107; patient survival P = .126). Kidney graft function after 1, 2, and 3 years was significantly better in the OD group than in the VOD group. No differences were found regarding postoperative complications, rejection rate, and delayed graft function.

Conclusion: The utilization of selected kidney-grafts from donors >75 years resulted in acceptable outcomes after kidney transplantation and could expand the donor pool. In contrast to the high mortality rate during dialysis, recipients in both groups benefited from transplantation.

MeSH terms

  • Adult
  • Aged
  • Brain Death
  • Delayed Graft Function / etiology
  • Delayed Graft Function / mortality
  • Female
  • Glomerular Filtration Rate
  • Graft Survival
  • Humans
  • Kidney
  • Kidney Transplantation / methods*
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Tissue Donors / supply & distribution*
  • Transplants / statistics & numerical data*