Recipient efficacy and safety of kidney transplantation from older living donor: consideration for using older kidney as a solution to the shortage of organs

Ji Yeon Song; Kyo Won Lee; Kyunga Kim; Kyeong Deok Kim; Jaehun Yang; Ji Eun Kwon; Okjoo Lee; Jae Berm Park

doi:10.4285/kjt.21.0020

Recipient efficacy and safety of kidney transplantation from older living donor: consideration for using older kidney as a solution to the shortage of organs

Korean J Transplant. 2021 Dec 31;35(4):238-246. doi: 10.4285/kjt.21.0020.

Authors

Ji Yeon Song¹, Kyo Won Lee¹, Kyunga Kim^{2

3}, Kyeong Deok Kim¹, Jaehun Yang¹, Ji Eun Kwon¹, Okjoo Lee¹, Jae Berm Park¹

Affiliations

¹ Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
² Biomedical Statistics Center, Data Science Research Institute, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea.
³ Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.

Abstract

Background: As a solution to organ shortages, studies on kidney transplantation (KT) from older donors are being conducted. However, many controversies remain about its safety and efficacy.

Methods: In Samsung Medical Center, from January 2000 to May 2015, 1,141 patients underwent living KT. Cases of retransplantation, recipient and donor aged younger than 18 years, and multiorgan transplantation were excluded, and a total of 859 cases were selected. Analysis was performed by dividing the patents into two groups a younger donor group (donors <60 years old; n=826) and an older donor group (donors ≥60 years old; n=33).

Results: There were no significant differences between the two groups in patient death (log-rank P=0.173) or in postoperative complications. The older donor group had a higher acute rejection (P=0.034; hazard ratio [HR], 1.704) and graft failure rate (P=0.029, HR=2.352). There was no significant difference in the trend of estimated glomerular filtration rate over time (P=0.189).

Conclusions: KT using kidneys from old-aged donors is safe, but there is room for improvement due to problems with higher acute rejection and graft failure rate.

Keywords: Aged; Kidney transplantation; Living donors.