Transplants of older kidneys work as well as younger ones

Recipients of kidneys from donors 55 years and older appear to have good outcomes, according to an article in the April issue of the Archives of Surgery, one of the JAMA/Archives journals.

According to the article, in the United States, the percentage of deceased kidney donors aged 55 and older has increased during the last decade. This is the result of both lower death rates (particularly from trauma) in people aged 18 to 35, and an increased acceptance of kidneys from older deceased donors. Although survival of the transplanted kidney may be diminished when it is from an older donor, giving these kidneys to older recipients, particularly those facing prolonged waiting times on dialysis, may be preferable to continuing with dialysis, the article states.

Paul E. Morrissey, M.D., from Brown Medical School, Providence, R.I., and colleagues investigated the risk of kidney allograft (the transplanted kidney) failure among patients treated at an academic transplant center in older (55-79 years) vs. younger (18 - 54 years) donors.

The researchers studied the records of 324 patients who received a kidney from an adult (18 or older) donor. Patients were divided into four groups based on donor status (living or deceased) and donor age (54 years or younger, or 55 years and older).

The researchers found that recipients of kidneys from donors 55 years or older were significantly older themselves (53.6 years vs. 43.6 years). Seven allografts (12.7 percent) failed from 55 transplants from donors 55 years and older, compared with 41 allografts (15.2 percent) from 269 younger donors. Kidney function was better following kidney transplant using younger donors, but kidney function was acceptable in all groups. Allograft survival at one, two, and three years after transplant did not differ when comparing older vs. younger donors.

The authors conclude: "Older donor kidneys provide good allograft function in most recipients. After proper evaluation, kidneys from older deceased or living donors are appropriate for selected candidates, including older patients awaiting transplantation and those with limited life expectancy based on their severity of illness."

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