Renal transplant from very old donors: how far can we go?

Abstract:

BACKGROUND:The organ shortage has led many transplant centers to accept kidneys from old, suboptimal deceased donors, and make increasing use of old-for-old allocation systems. We report the experience of an Italian transplant center in the utilization of "ultra-old" (>75 years old) donors. METHODS:Sixty grafts from donors aged 75 years or older (mean age 79.1 years, range 75-90 years) were used for 38 patients: 16 as single and 22 as double transplants. RESULTS:The actuarial graft survival rate was 73.7% for year 1, 69.8% for year 2, and 64.0% for year 3. The patient survival rate was 81.2% and remained stable for years 1, 2, and 3. The delayed graft function rate was 57.9%. Acute rejection and chronic allograft nephropathy rates were comparable with our other expanded criteria donors. The majority of the patients had stable creatinine levels, between 2 and 3 mg/mL after the second month, with sufficient creatinine clearance. CONCLUSIONS:Our results seems encouraging with patient and graft survival rates, complication rates, and renal function parameters being slightly worse than in expanded criteria donors, but still generally acceptable. The use of old kidneys in old recipients, bearing in mind their usual life expectancy, gives them a properly functioning kidney and improved quality of life.

journal_name

Transplantation

journal_title

Transplantation

authors

Collini A,Kalmar P,Dhamo A,Ruggieri G,Carmellini M

doi

10.1097/TP.0b013e3181a6b4ff

subject

Has Abstract

pub_date

2009-06-27 00:00:00

pages

1830-6

issue

12

eissn

0041-1337

issn

1534-6080

pii

00007890-200906270-00011

journal_volume

87

pub_type

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