Long-Term Followup of Elderly Donors in a Live Related Renal Transplant Program

Kumar, Anant; Verma, Balbir S; Srivastava, Aneesh; Bhandari, Mahendra; Gupta, Amit; Sharma, Raj Kumar

doi:10.1097/00005392-200006000-00006

Cited by 16 publications

(36 citation statements)

References 19 publications

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“…with the literature we do not report a difference in perioperative complication rate between younger and older donors (16,(19)(20)(21). This may be the result of the selection process including donors with no or minor comorbidity only.…”

Section: Older Living Kidney Donorscontrasting

confidence: 62%

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Living Kidney Donors: Impact of Age on Long-Term Safety

Dols

Kok

Roodnat

et al. 2011

American Journal of Transplantation

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The safety of older live kidney donors, especially the decline in glomerular filtration rate (GFR) after donation, has been debated. In this study we evaluated long-term renal outcome in older live kidney donors. From 1994 to 2006 follow-up data of 539 consecutive live kidney donations were prospectively collected, during yearly visits to the outpatient clinic. Donors were categorized into two groups, based on age: <60 (n = 422) and ≥60 (n = 117). Elderly had lower GFR predonation (80 vs. 96 mL/min respectively, p < 0.001). During median follow-up of 5.5 years, maximum decline in eGFR was 38% ± 9% and the percentage maximum decline was not different in both groups. On long-term follow-up, significantly more elderly had an eGFR <60 mL/min (131 (80%) vs. 94 (31%), p < 0.001). However, renal function was stable and no eGFR of less than 30 mL/min was seen. In multivariate analysis higher body mass index (HR 1.09, 95%CI 1.03-1.14) and more HLA mismatches (HR 1.17, 95%CI 1.03-1.34) were significantly correlated with worse graft survival. Donor age did not influence graft survival. After kidney donation decline in eGFR is similar in younger and older donors. As kidney function does not progressively decline, live kidney donation by elderly is considered safe.

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Section: Older Living Kidney Donorscontrasting

confidence: 62%

“…We even included a group of 25 donors older than 70 years. The average age in this study is relatively high, in particular when compared to American studies (16)(17)(18). Results of the present study may encourage other centers to include healthy older donors.…”

Section: Discussionmentioning

confidence: 65%

Living Kidney Donors: Impact of Age on Long-Term Safety

Dols

Kok

Roodnat

et al. 2011

American Journal of Transplantation

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“…Graft survival in recipients of kidneys from LD 455 years of age 5 and from donors 460 years of age [6][7][8][9] did not differ from those who received kidneys from younger donors. Nevertheless, these data from small, usually single-center studies has been recently challenged by the systematic review by Iordanous et al in which recipients of kidneys from donors 460 years of age were found to have poorer 5-year patient and graft survival than recipients from younger donors.…”

Section: Discussionmentioning

confidence: 82%

Does donor–recipient age difference matter in outcome of kidney transplantation? Implications for kidney paired donation

et al. 2013

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Background: Kidney paired donation (KPD) is a rapidly growing modality for facilitating living donor kidney transplantation (LDKTx) for patients who are incompatible with their healthy, willing and living donor. The impact of donor-recipient age difference on long and short-term graft and patient survivals in LDKTx is still uncertain. Methods: A total of 1502 LDKTx recipients who received regular follow-up in our center from 1999 to 2012 were studied. Donor-recipient age difference was divided into subgroups (donor-recipient 0À10, 11-20, 0-20, 21-30, 31-40, and 21-40 years). Outcome measures included death censored graft, patient survival and acute rejection rate. Results: The 1-, 5-, 10-year patient survival of the donor-recipient age difference 20 years group showed no difference compared with the age difference 420 years group (94.5%, 83.2%, 71.9% and 95.2%, 86%, 77.8%, p ¼ 0.053). The 1-, 5-, 10-year graft survival of the donor-recipient age difference 20 years group showed no difference compared with the age difference420 years group (94.6%, 81.6%, 72.1% and 94%, 80%, 72.2%, p ¼ 0.989). The rejection were also similar (17.5% vs. 16.5%, p40.05). There was no statistically significant difference in graft survival and acute rejection rate in all subgroups. Conclusions: Older donors (usually within families) are not associated with worse outcome is reassuring. KPD should not be prohibited due to high donor-recipient age difference, when size of donor pool is small as in single center KPD program.

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“…The association between donor age and outcome adjusted for relevant factors such as recipient age was examined in three studies (Table 7) (26,35,47 (25,37,38,46 (25,32,(36)(37)(38)41,42). The association between donor age and Expanded Criteria Donors and Recipient Outcomes (25,26,34,48). (24)(25)(26)36,37,48,49 …”

Section: Description Of Included Articlesmentioning

confidence: 99%