The Impact of Elderly Donor in Renal Transplantation

Park, Pil Kyung; Kwon, Oh Jung; Kang, Chong Myung

Abstract

PURPOSE: Kidney transplantation from elderly donors is controversial because of decline of received renal function and increased risk of perioperative complication.
METHODS
We retrospectively reviewed the records of the 676 patients from 1985 to 2006 in our center. 42 (6.2%) donors were > or =60 years old, and constitue the group 1, and 634 donors (93.8%) were <60 years old (group 2). We analysis graft survival, preoperative and postoperative creatinine, creatinine clearance, acute rejection rate, infection rate, delayed graft fucntion rate, HLA matching between groups.
RESULTS
The average donor age in group 1 is 62.8 yr (60~73) and 39.3 yr (16~59) in group 2. Graft survival rate at 1, 5 and 10 years were 92%, 71%, 56% in group 1 vs 92%, 77%, 62% in group 2 (P=0.0831). There was no difference of graft survival between groups. In preoperative serum creatinine or postoperative days 3, 30 creatinine there was not difference between groups. Infection rate was 9.5% (4 patients) in group 1 vs. 7.3% (46 patients) in group 2. Acute rejection rate was 28.6% (12 patients) vs. 30.9% (196 patients). Delayed graft function (DGF) rate was 7.1% (3 patients) vs. 9.0% (57 patients). HLA-AB matching was 1.86 vs. 1.78 and HLA-DR matching was 1.12 vs. 1.06. All were not significantly different between groups. But the elderly donor group has a lower creatinine clearance at postoperative 3, 30 days (P=0.0422, 0.0231).
CONCLUSION
The short and long-term survival of kidney transplantation from elderly donors (> or =60) are similar to younger donors (<60). We suggest that use of elderly donors may help to expand the donor pool in kidney transplantation.