Effect of donor age and parent-to-child transplant on living-related donor kidney transplantation: a single center's experience of 236 cases

Abstract

To study the impact of parent-to-child transplant and older donor age on recipients' posttransplant creatinine levels, a total of 236 patients who received living donor kidney transplantation were evaluated for kidney viability based on creatinine (Cr) level. Of the 236 pairings, 113 (48%) were parent-to-child followed by sibling transplants (66, 30%). Recipient Cr levels were significantly higher at 6 months and 3 years post-transplant in the parent-to-child transplants compared to other donor-recipient relationships. In addition, donor age (average age: 44.1 ± 11.5; range: 19-66) contributed to higher recipient post-transplant Cr levels (p50.01). Pre-transplant donor and recipient Cr levels tended to result in higher post-transplant Cr levels in recipients (p50.05). Multivariate logistic regression analysis revealed that the presence of both parent-to-child transplant and older donor significantly increased the risk of elevated post-transplant Cr levels in recipients with an estimated odds ratios ranging from 3.46 (95% CI: 1.71-6.98) at 6 months to 8.04 (3.14-20.56) at 3 years post-transplant. Donor age significantly affected transplant survival as measured by higher recipient post-transplant Cr levels. In addition, parent-to-child transplant pairings, along with older donor age, significantly increased the risk of elevated post-transplant Cr levels in recipients.

Outcomes With Age Combinations in Living Donor Kidney Transplantation

“…Formerly, related donors were deemed as optimum candidates, though recent studies have provided evidence against this notion. 8,9 Our results support current theories, indicating that unrelated donors are also a quality resource and should be considered. It is known that older patients are now the fastest growing group of patients requiring renal transplant and show reduced mortality compared to patients on the waitlist and long-term dialysis.…”

Association of donor hypertension and recipient renal function in living donor kidney transplantation: A single‐center retrospective study

“…Whereas, donor age and predonation estimated glomerular filtration rate (eGFR) have been known to be important predictors of recipient graft function, and little is known whether donor hypertension is associated with recipient renal function. In kidneys from deceased donors, hypertension is often a reason for not accepting the organ, due to fear of inferior graft function .…”

Is ABO Incompatible Living Donor Kidney Transplantation in Children a Better Option than the Use of Optimal Grafts From Deceased Donors? A Plea for Better Prioritization of Deceased Kidney Grafts for Children

“…Furthermore, while transplants from living donors generally have a better prognosis than transplants from deceased donors, it should be noted that parents who are candidates for donation are increasingly older and have more co-morbidities [ 3 ], whereas children often receive transplants from young deceased donors whose parenchyma is generally well preserved at the time of donation. This may partly reduce the advantages of living donation in pediatric kidney transplantation.…”