BOSTON — Kidneys from donors aged 70 years or older were effective in transplantation and should be considered for the procedure, according to results of a poster presented at the American Transplant Congress.
“With the increasing number of patients on the kidney transplant waitlist and with improved technique and management, the demand for kidneys is constantly increasing,” Rainer W. Gruessner, MD, FACS, FICS, of SUNY Downstate Medical Center, and colleagues wrote. “The use of ‘expanded criteria donors’ offers a possibility to receive a transplant. Questionable is the maximum age of a possible kidney donor.”
Researchers examined 2,337 kidney transplants from donors aged 70 years or older that had been performed between 1998 and 2017 (84% from deceased donors; 16% from living donors). The oldest deceased donor was 88 years and the oldest living donor was 84 years. For the recipients, the youngest transplanted with a deceased donor kidney was 7 years old and the oldest was 86 years old (median age, 66 years).
Researchers noted that most donors for the younger group of recipients were parents, while most of those donating to the older group were spouses. To determine influential factors for patient and graft survival, researchers performed comprehensive univariate and multivariate analyses.
Researchers found the half-life of living donor kidneys reached 8 years and the half-life of deceased donor kidneys reached 6.5 years. It was further observed that while that there were significant improvements in deceased donor transplants with time, the results for living donor transplants remained unchanged and were superior.
Finally, it was determined that the most influential risk factors for deceased donor graft function were if the recipient was older than 65 years (RR = 1.40), if the recipient was a man (RR = 1.22) and if the recipient had type 2 diabetes (RR = 1.28). For living donor transplants, only type 2 diabetes was a significant risk factor for graft function (RR = 2.71).
“Kidney transplantation from selected donors aged 70 years or older can be successful and should be considered especially for older recipients,” the researchers wrote. “In this selected population, only diabetes and being on dialysis carried an increased risk.” – by Melissa J. Webb
Gruessner RW. B154. Presented at: American Transplant Congress. June1-5, 2019; Boston.
Disclosure: Gruessner reports no relevant financial disclosures.