In order to expand the donor pool, the utilization of kidneys otherwise discarded because of extremely old age or comorbidities has been evaluated.

We retrospectively analyzed the results of kidney transplantations using deceased donors aged 80 or above, performed at a single Center. We also compared the characteristics of the utilized donors (UD) aged 80 with the characteristics of discarded donors (DD) aged ≥80. Between January 2006 and August 2016 we performed 40 kidney transplantations using kidneys procured from deceased donors aged ≥80 yr; according to pre-transplant histological score, we performed 34 dual kidney transplantations (DKT) and 6 single kidney transplantations (SKT). 34 donors were discarded (61% severe atherosclerotic lesions, 14% neoplasia, 14% parenchymal macroscopic alterations, 11% histological score).

We didn't find any statistical difference between UD and DD concerning renal function, donor's characteristics and comorbidities: UD median serum creatinine was 77 ml/min/1,73 m2 (IQR 66-90), DD median serum creatinine was 84 ml/min/1,73 m2 (IQR 71-98) (p=0.41). Hypertension affected 78% of UD and 79% of DD (p=0.99). CV was the cause of death in 85% of UD and 86% of DD (p=0.99).

After a median follow-up of 25 months, 4 deaths occurred with functioning graft. Patient survival at 1 and 5 years after transplantation is 100% and 69% respectively. Graft loss occurred in 2 patients because of acute rejection. Death censored graft survival at 1 and 5 years is 94%. Delayed graft function occurred in 5 cases (median duration 5 days). Median serum creatinine at 1 year and 5 years is 132 [mu]mol/l (IQR 93-161) and 112 [mu]mol/l (IQR 87-119) respectively. Median creatinine clearance at 1 and 5 years is 50 ml/min/1,73 m2 (IQR 35-59) and 61 ml/min/1,73 m2 (IQR 55-62) respectively.

Donors aged ≥80 allowed to perform successful SKT or DKT following histological evaluation. UD and DD showed similar clinical characteristics and renal function, indicating that macroscopical evaluation has a major role in the process of aged kidneys discard.

CITATION INFORMATION: Donato P, Furian L, Silvestre C, Neri F, Di Bella C, Di Bello M, Rigotti P. Outcome of Kidney Transplantation from Deceased Octogenarian Donors. Am J Transplant. 2017;17 (suppl 3).

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