Graft survival(GS) perception is that, with a smaller age gap between the donor(D) and recipient(R), better the outcome. It is unclear if there is an age-gap limit at which the benefit in GS disappears. We chose to analyze graft failure(GF)rates among R of living donors(LD) with an incremental D minus R age gap. We compared such groups to standard criteria deceased donors(SCD)transplants.

Methods: Using the UNOS database from 1995 to 2013, we evaluated GF involving LD with R ages 18-79 from 1995 onward. We compared GF among R from LD with an age-gap, D minus R, of <10, 10-14, 15-19, 20-24, 25-30 and 30+. These age-gap groups were compared to SCD R. D and R demographic and transplant data were used to allow Cox regression analysis. Endpoints were plotted using Kaplan-Meir analysis.

Results: When D are older than R, Cox regression analysis(n=13,930)showed no statistical difference in GF comparing a D-R age-gap less than 10 vs age-gap 10-14(p 0.636).There was a significant increase in GF in age-gap 15-19 (n=3,127)compared to 10-14 (P<0.001, HR 1.55).There was no GF difference comparing remaining age-gap groups.Kaplan-Meier curve confirmed findings.Fig1

Comparing LD R of same age-gap groups with R of SCD(n=29,058) a statistical significance decreased in GF was found between age-gap<15 (p<0.001, HR 0.67).There was no statistical difference between the wider age-gap groups and SCD R. When R are older than D, Cox regression analysis(n=41,881) showed that age-gap of <10 had statistically significant improved GF compared to age gap>10(p<0.001, HR 1.18)however, it was not significant when compared to age gap >15 (p=0.1).

Conclusions: There appears to be a statistical significant benefit on GF within LD R if the age-gap is <15 compared to age gap>15. Within age gap groups of >15, there was no difference in GF. LD R had decreased GF when compared to SCD R, if age gap was <15, but not if gap was>15.For R older than D,there is no GF benefit with an age gap of >15 compared to <15.

CITATION INFORMATION: Rodriguez J, Patel A, Goggins M. Age Gap Analysis Between Live Donor and Recipients in Kidney Transplantation: Opportunities to Improve Voluntary Exchange Programs and Kidney Paired Donation. Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress