Age‐matching in renal transplantation

Background. So far, the combined influence of donor age and recipient age on renal allograft survival has not been investigated sufficiently. In this retrospective single‐centre study we analysed whether the influence of donor age and recipient age on renal allograft survival are dependent on each o...

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2000-05, Vol.15 (5), p.696-700
Main Authors: Waiser, Johannes, Schreiber, Matthias, Budde, Klemens, Fritsche, Lutz, Böhler, Torsten, Hauser, Ingeborg, Neumayer, Hans‐H.
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Adult
age‐matching
Aging
Biological and medical sciences
Chronic Disease
Graft Rejection - epidemiology
Graft Survival
Humans
Incidence
Kidney Transplantation
Medical sciences
Middle Aged
Multivariate Analysis
renal transplantation
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Tissue Donors
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Summary:Background. So far, the combined influence of donor age and recipient age on renal allograft survival has not been investigated sufficiently. In this retrospective single‐centre study we analysed whether the influence of donor age and recipient age on renal allograft survival are dependent on each other. Methods. Data from 1269 cadaveric renal allograft transplantations were evaluated. Paediatric donors (55 years, n=211). Functional and actual long‐term graft survival (8 years) within the four resulting groups was determined: yd/yr (n=926), yd/or (n=167), od/yr (n=132), and od/or (n=44). Results. Univariate analysis showed that long‐term graft survival of both, kidneys from young donors (functional, 66.1 vs 52.2%, P=0.004; actual, 53.3 vs 46.2%, P=0.065) and kidneys from old donors (functional, 68.7 vs 22.5%, P=0.07; actual, 57.1 vs 20.8%, P=0.15) was better in old recipients as compared to young recipients. Multivariate regression analysis revealed that actual graft survival of kidneys from old donors was significantly reduced in young recipients (od/yr) as compared to all other groups (P=0.001; RR, 1.97; 95% CI, 1.32–2.94). In this group of patients, graft loss was mainly due to acute (33.7%) and chronic (24.0%) rejection. Conclusion. Transplantation of kidneys from ‘old’ donors into ‘young’ recipients should be avoided, and these kidneys should be given to age‐matched recipients.
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/15.5.696