[Ten years of the Eurotransplant senior program : are there still age limits for kidney transplantation?].

On 1 January 1999 Eurotransplant started the "Eurotransplant Senior Program" (ESP), the first program worldwide for age-matched kidney allocation and transplantation of expanded criteria donors (ECD). By now more than 4.300 kidneys from donors aged > or =65 were transplanted into recipients > or =65, with local or regional allocation according only to blood group compatibility and waiting time. Compared to ongoing dialysis, renal transplantation in the ESP offers longer patient survival and improved quality of life. The article evaluates the results of the ESP and of other studies dealing with renal transplantation of old donor kidneys into aged recipients. Specific aspects like the unexpectedly high acute rejection rate and ways to assess the residual renal function of aged donor kidneys are covered as well as the specific post-transplant risks of aged recipients.