Impact of donor age on living related donor kidney transplantation

Abstract

Two comparable groups of kidney transplant recipients were identified according to the age of their kidney donors. The first group (A) comprised 42 recipients of donors aged < 40 years, and the second group (B) comprised 48 recipients of donors aged >50 years. The patients were followed for a mean period of 26 months (range 13-50 months). Post-transplant renal function and graft survival were assessed together with the frequency of post-transplant proteinuria and hypertension. Moreover, the functional reserve of the grafts was determined by comparing the clearance values, obtained by both isotope and chemical means, before and after a combined infusion of dopamine and an amino acids preparation. The graft function was significantly better in group A according to the serum creatinine levels (J.tmol/1) at 1 month (107 ± 4.5 vs. 134 ± 10.7, P < 0.01), 12 months (119 ± 5.3 vs. 181 ± 88, P < 0.05) and at last follow-up visit (118 ± 6.2 vs. 223 ± 63, P < 0.03) for groups A and B, respectively. The graft survival in group A was significantly higher than that in group B (100% vs. 87% at 1 year, P < 0.05). The graft functional reserve was significantly better in group A than in group B. Post-transplant proteinuria was significantly more frequent in group B recipients (70% vs. 40%, P < 0.03). The age of the donors had no impact on the incidence of post-transplant hypertension. These observations suggest that the transplantation of a kidney from an older live kidney donor is associated with an inferior post-transplant outcome.

Five decades with grandparent donors: The Norwegian strategy and experience

“…The acceptance of older LD for children has been controversial. Especially for children, the main policy has been “young‐for‐young.” Decreased functional reserve, a higher risk for hypertension, and vascular disease have been the reason for not accepting older donors 10,11 …”