Living Kidney Donors Ages 70 and Older

Abstract

SummaryBackground and objectives The profound organ shortage has resulted in longer waiting times and increased mortality for those awaiting kidney transplantation. Consequently, patients are turning to older living donors. It is unclear if an upper age limit for donation should exist, both in terms of recipient and donor outcomes.Design, setting, participants, & measurements In the United States, 219 healthy adults aged Ն70 have donated kidneys at 80 of 279 transplant centers. Competing risks models with matched controls were used to study the independent association between older donor age and allograft survival, accounting for the competing risk of recipient mortality as well as other transplant factors.Results Among recipients of older live donor allografts, graft loss was significantly higher than matched 50-to 59-year-old live donor allografts (subhazard ratio [SHR] 1.62, 95% confidence interval [CI] 1.16 to 2.28, P ϭ 0.005) but similar to matched nonextended criteria 50-to 59-year-old deceased donor allografts (SHR 1.19, 95% CI 0.87 to 1.63, P ϭ 0.3). Mortality among living kidney donors aged Ն70 was no higher than healthy matched controls drawn from the NHANES-III cohort; in fact, mortality was lower, probably reflecting higher selectivity among older live donors than could be captured in National Health and Nutrition Examination Survey III (NHANES-III; HR 0.37, 95% CI 0.21 to 0.65, P Ͻ 0.001).Conclusions These findings support living donation among older adults but highlight the advantages of finding a younger donor, particularly for younger recipients.

Analysis of Factors Influencing on Living Kidney Donors and Deceased Kidney Donors Transplantation Results

“…Berger et al analysed kidney transplantation results of kidney harvested from a living kidney donors older than 70 years old and they proved there is a correlation between donor's age and transplantation results. However, results are comparable with results of kidney transplantation that were harvested from cadaveric standard criteria donors [2]. In our research there was a correlation between donor's age and kidney function -the older donors were, the higher creatinine serum concentration at recipient.…”

Kidney Transplantation From Elderly Donor

“…Mortality among living kidney donors aged >70 years was no higher than healthy matched controls drawn from the NHANES-III cohort; in fact, mortality was lower, probably reflecting higher selectivity among older live donors than could be captured in National Health and Nutrition Examination Survey III [5].…”

Living donor age and kidney transplant outcomes: an assessment of risk across the age continuum

“…In light of the known decrease in glomerular filtration rate with advancing age, several studies have sought to establish the relation between donor age and allograft failure and function following LDKT [9][10][11][12][13]. A recent study by Chang et al [14] showed that, with the exception of recipients aged 18-39 years who had the best outcomes with donors aged 18-39 years, living donor age between 18 and 64 years had minimal effect on the half-life of kidney allografts.…”

“…The studies included in this review were mostly small single-center reports and demonstrated significant between-study heterogeneity [15]. More recent studies have focused on the outcomes of kidney transplants from the oldest living donors (i.e., 70 years) [9,10] or had insufficient power to detect nonlinear associations [12,13].…”