Objective: Analyze post-transplant outcomes in older recipients of kidney transplants from older live donors compared to older recipients of standard criteria deceased donor kidney transplants.

Methods: We analyzed UNOS dataset for transplant recipients aged 65 years or older at transplantation. Patients were divided into two groups. The first group consisted of individuals who received kidney from a live donor aged 65 years or older. The second group consisted of individuals who received a kidney from a standard criteria deceased donor. Graft and patient survival was compared by Kaplan Meier and Cox regression techniques.

Results: We identified 17,193 individuals aged 65 years or older who underwent a kidney transplant between 10/1987 and 3/2013. Of these, 561 individuals with a mean age of 69 years received a kidney from a live donor aged 65 years or older at time of surgery. The mean age of live donors was 68 years. During this period 16,632 individuals aged 65 years or older received a standard criteria deceased donor kidney transplant. Mean recipient age in this second group was 69 years while the mean age for the standard criteria deceased donors was 35 years. Graft survival at up to ten years of follow-up was comparable in patients who received a kidney from a live donor to those who received a kidney from a standard criteria deceased donor (HR=0.91, 95%CI=0.78-1.05; p=0.21 ). Patient survival on the other hand was superior in individuals who had a live donor kidney transplant (HR=0.82, 95%CI=0.69-0.97; p=0.02; figure).

Conclusions: These data indicate that in kidney transplant recipients aged 65 years or older a live donor kidney transplant from donors aged 65 years or older is expected to offer a survival advantage compared to kidney transplantation from standard criteria deceased donors. Live donor kidney transplantation under such circumstances should be the preferred modality whenever feasible.

CITATION INFORMATION: Abrams P, Cooper M, Verbesey J, Ghasemian R, Grafals M, Gilbert A, Moore J, Fenton J, Cannon C, Rapisurra J, Javaid B. Survival Advantage with Older Live Donor Compared to Standard Criteria Deceased Donor Kidney Transplantation in Older Recipients. Am J Transplant. 2016;16 (suppl 3).

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