Cadaveric kidney donation beyond the age of 60 years — a comparative analysis of 1180 grafts from different donor age groups

Abstract

The impact of high donor age on transplantation outcome was analysed in 1180 consecutive cadaveric grafts transplanted in adult recipients. Grafts were divided into three groups acording to donor age (< 55 years (n = 1073, group 1), 55-59 years (n = 51, group 2), > or = 60 years (n = 56, group 3)) and transplantation outcome was compared for these groups. Criteria investigated were the incidence of primary non-function (PNF), initial function (IF) (urine production first 24 h) and long-term function (LTF). The impact of donor age on LTF was analysed among other potential donor, graft and recipient risk factors by the multivariate proportional hazardous model analysis (Cox model). The incidence of PNF was 5.8% (group 1), 11.8% (group 2), and 16.1% (group 3) (P = 0.002). Analysis of paired kidneys of PNF grafts in group 2 and group 3 revealed good function for all paired grafts except for one in each group. IF was anuria in 19.7% of group 1, 29.4% group 2 and 21.5% of group 3, oliguria in 18.2% of group 1, 23.5% of group 2 and 32% of group 3. Normal diuresis was found in 62.1% of group, 47.1% of group 2 and 47.3% of group 3 (P = 0.05). Independent risk factors for graft survival were year of transplantation, recipient age, panel reactive antibodies, donor age group and number of transplantation. After the exclusion of PNF grafts from the analysis, recipient age, year of transplantation and level of panel reactive antibodies remained as independent risk factors.