*Purpose: With the increasing number of patients on the kidney transplant waitlist and with improved technique and management the demand for kidneys is constantly increasing. The use of ‘Expanded criteria donors’ (ECD) offer a possibility to receive a transplant. Questionable is the maximum age of a possible kidney donor.

*Methods: All 2337 kidney transplants from donors of the age of 70 years or older performed between 1998 and 2017. In most of the cases the kidney was used for a primary transplant (95%). The majority of kidneys came from deceased donors (DD) (84%) but also 369 (16%) transplants from living donors (LD) were noted. Comprehensive uni- and multivariate analyses of influential factors for patient and graft survival were performed.

*Results: The oldest deceased kidney donor was 88years, the oldest living donor was 84 years old. Figure 1 shows the age distribution by donor type

. The youngest DD kidney recipient was 7 the oldest 86 years old. The median age was 66 years. The distribution for LD kidneys was bimodal with one peak at 45 and another one at 70years. The majority of donors for the younger group were parents donating to offspring, in the older group the majority were spouses. Figure 2 shows the kidney graft function by donor type

. While significant improvement in DD transplants over time was noted, the results in LD remained unchanged but were overall superior. The half-life of LD kidneys reached 8 years, of DD kidneys 6.5years. The most influential risk factor for DD graft function were recipient age over 65 years (RR=1.40, 1.22-1.60), male gender ((RR=1.22, 1.07-1.39 and type 2 diabetes (RR=1.28, 1.10-1.47). In LD transplants only type 2 diabetes reach significance (RR=2.71, 1.51-4.86).

*Conclusions: Kidney transplantation from selected donor of the age of 70 years and older can succeed and should be considered especially for older recipients.

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