BACKGROUND: The use of elderly donors is becoming more frequent. An increase in the donor's age is associated with a greater incidence of delayed graft function (DGF), chronic allograft nephropathy (CAN) and worse graft survival. Poor renal graft function is a risk factor for cardiovascular (CV) complications and, finally, for mortality of the patients. METHODS: A total of 3365 adult patients transplanted in 1990 (n = 824), 1994 (n = 1075) and 1998 (n = 1466) with a functioning graft after the first year were included. The impact of donor age on renal function, DGF, acute rejection and other clinical factors was evaluated according to two donor and recipient age categories: young (< 60 years old) and elderly (> or =60 years old). Additionally, donor age was categorized by decades for the analysis of patient and graft survival, acute rejection and CV mortality. RESULTS: Donor mean age significantly increased during the three transplantation periods. A total of 478 out of 3365 donors were older than 60 years. Elderly donors showed an increased risk of DGF (38.9 vs 28.8%) and CAN (56.8 vs 46.2%). Mean serum creatinine at 3 and 12 months and proteinuria were significantly higher in the old donor group. Incidence and severity of acute rejection were similar in both groups. Graft and patient survival were significantly lower in the old donor group. Also, risk of mortality due to CV events was also significantly higher. A linear increase in risk of graft loss, patient death or CV mortality was observed when donor age was divided into 10 year increase subsets. CONCLUSIONS: Donor age is a strong predictor of CAN and graft loss. Patient survival is also affected by donor age, particularly by a higher risk of CV mortality.
BACKGROUND: The use of elderly donors is becoming more frequent. An increase in the donor's age is associated with a greater incidence of delayed graft function (DGF), chronic allograft nephropathy (CAN) and worse graft survival. Poor renal graft function is a risk factor for cardiovascular (CV) complications and, finally, for mortality of the patients. METHODS: A total of 3365 adult patients transplanted in 1990 (n = 824), 1994 (n = 1075) and 1998 (n = 1466) with a functioning graft after the first year were included. The impact of donor age on renal function, DGF, acute rejection and other clinical factors was evaluated according to two donor and recipient age categories: young (< 60 years old) and elderly (> or =60 years old). Additionally, donor age was categorized by decades for the analysis of patient and graft survival, acute rejection and CV mortality. RESULTS:Donor mean age significantly increased during the three transplantation periods. A total of 478 out of 3365 donors were older than 60 years. Elderly donors showed an increased risk of DGF (38.9 vs 28.8%) and CAN (56.8 vs 46.2%). Mean serum creatinine at 3 and 12 months and proteinuria were significantly higher in the old donor group. Incidence and severity of acute rejection were similar in both groups. Graft and patient survival were significantly lower in the old donor group. Also, risk of mortality due to CV events was also significantly higher. A linear increase in risk of graft loss, patientdeath or CV mortality was observed when donor age was divided into 10 year increase subsets. CONCLUSIONS:Donor age is a strong predictor of CAN and graft loss. Patient survival is also affected by donor age, particularly by a higher risk of CV mortality.
Authors: María José Pérez-Sáez; Núria Montero; Dolores Redondo-Pachón; Marta Crespo; Julio Pascual Journal: Transplantation Date: 2017-04 Impact factor: 4.939
Authors: Sanjay Kulkarni; Guo Wei; Wei Jiang; Licia A Lopez; Chirag R Parikh; Isaac E Hall Journal: Am J Kidney Dis Date: 2019-12-05 Impact factor: 8.860
Authors: Maike van Huis; Nikki J Schoenmaker; Jaap W Groothoff; Johanna H van der Lee; Karlien Cransberg; Antonia H M Bouts; Laure Collard; Maria van Dyck; Nathalie Godefroid; Koenraad van Hoeck; Christina Taylan; Linda Koster-Kamphuis; Marc R Lilien; Ann Raes; Nadedja Ranguelov Journal: Pediatr Nephrol Date: 2013-01-16 Impact factor: 3.714
Authors: Donald E Hricik; Emilio D Poggio; Kenneth J Woodside; Naragaju Sarabu; Edmund Q Sanchez; James A Schulak; Aparna Padiyar; Peter S Heeger; Joshua J Augustine Journal: Transplantation Date: 2013-05-27 Impact factor: 4.939