Ngan N Lam1, Amit X Garg. 1. aDepartment of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta bDepartment of Medicine, Division of Nephrology, Western University, London, Ontario, Canada.
Abstract
PURPOSE OF REVIEW: Kidney transplantation from a living kidney donor (LKD) is associated with better long-term survival and quality of life for a patient with end-stage renal disease (ESRD) than dialysis. We reviewed recent literature on the acceptability and outcomes of older adults as LKDs, which may be misunderstood in routine care. RECENT FINDINGS: Studies report that receiving a kidney from an older LKD is associated with worse recipient and graft survival compared with receiving a kidney from a younger LKD, but similar recipient and graft survival to receiving a kidney from a standard criteria deceased donor. A kidney from a younger vs. older LKD results in better graft survival in younger recipients, whereas the graft survival is similar in older recipients. Compared with healthy matched nondonors, older LKDs have a similar risk of death and cardiovascular disease and the absolute risk of ESRD after 15 years remains less than 1%. The estimated predonation and postdonation lifetime risk of ESRD varies by age, sex and race with lower incidences in individuals who are older, female and white (vs. African-American). SUMMARY: Donor and recipient outcomes from several studies support the acceptability of older adults as LKDs.
PURPOSE OF REVIEW: Kidney transplantation from a living kidney donor (LKD) is associated with better long-term survival and quality of life for a patient with end-stage renal disease (ESRD) than dialysis. We reviewed recent literature on the acceptability and outcomes of older adults as LKDs, which may be misunderstood in routine care. RECENT FINDINGS: Studies report that receiving a kidney from an older LKD is associated with worse recipient and graft survival compared with receiving a kidney from a younger LKD, but similar recipient and graft survival to receiving a kidney from a standard criteria deceased donor. A kidney from a younger vs. older LKD results in better graft survival in younger recipients, whereas the graft survival is similar in older recipients. Compared with healthy matched nondonors, older LKDs have a similar risk of death and cardiovascular disease and the absolute risk of ESRD after 15 years remains less than 1%. The estimated predonation and postdonation lifetime risk of ESRD varies by age, sex and race with lower incidences in individuals who are older, female and white (vs. African-American). SUMMARY:Donor and recipient outcomes from several studies support the acceptability of older adults as LKDs.
Authors: Fawaz Al Ammary; Xun Luo; Abimereki D Muzaale; Allan B Massie; Deidra C Crews; Madeleine M Waldram; Mohamud A Qadi; Jacqueline Garonzik-Wang; Macey L Henderson; Daniel C Brennan; Alexander C Wiseman; Richard C Lindrooth; Jon J Snyder; Josef Coresh; Dorry L Segev Journal: Clin J Am Soc Nephrol Date: 2019-06-25 Impact factor: 8.237
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