The Effect of Donor Nephrectomy in the Older Living Kidney Donor: Single Centre Experience
West Lodnon Renal and Transplant Centre, Imperial College NHS Trust, London, United Kingdom.
Meeting: 2018 American Transplant Congress
Abstract number: B167
Keywords: Age factors, Donation, Donors, marginal
Session Information
Session Name: Poster Session B: Kidney Living Donor: Long Term Outcomes
Session Type: Poster Session
Date: Sunday, June 3, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background. Living kidney donor transplantation is the best treatment for ESRD and considered safe for the donor. We aimed to investigate short and medium-term outcomes of older donors post-donation.
Methods. We prospectively collected data on 579 consecutive live donors in Imperial College Renal and Transplant Center during 2002-2015. Donors were categorized as older (≥ 60years) or younger (<60years). We analyzed data for kidney function [24hr Creatinine-Clearance(CrCl) and CKD-EPI], proteinuria (24h-urine protein) and blood pressure control. Loss of GFR≥5ml/min/1.73m2 per year was defined as progressive CKD. Hypertension was defined as BP>140/90mmHg on ≥2 separate occasions.
Results. A total of 579 (334 female) donors were included. Mean age at donation was 46.8+13 years. 44 (8.4%) donors were over 60 and followed-up for 38.18+26.7 months. Older donors had significantly lower CrCl (ml/min) pre-donation (mean 99 Vs 111, p=0.01) and the difference remained significant at 1 year (mean 68 Vs 84, p=0.01), 3 years (70 Vs 87), p=0.1) but not at 5 years (80 Vs 92,p=0.27). When CKD-EPIeGFR was used this difference persisted at 5 years (72 Vs 78, p=0.03). GFR<60ml/min/1.73m2 at the end of follow up was more prevalent in older donors both with CrCl and CKD-EPIeGFR (p=0.013, p<0.001 respectively). However, there was no difference in progressive function deterioration between the two groups (p=0.4, p=0.3 respectively). Moreover, there was no difference in proteinuria between the groups (p=0.127). Although older donors were more likely to be hypertensive pre-donation, there was no significant difference in developing post-donation hypertension between the groups (p=0.19).
Conclusions. Donor nephrectomy in the elderly appears to be safe. As expected, our study shows that older donors have lower pre- and post-donation CrCl and CKD-EPIeGFR, however this is not accompanied by more prevalent progressive kidney disease, proteinuria or post-donation hypertension.
CITATION INFORMATION: Koutroutsos K., Kousios A., Charif R., Galliford J., Stubbs N., Dulku H., Orr H., Loucaidou M. The Effect of Donor Nephrectomy in the Older Living Kidney Donor: Single Centre Experience Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Koutroutsos K, Kousios A, Charif R, Galliford J, Stubbs N, Dulku H, Orr H, Loucaidou M. The Effect of Donor Nephrectomy in the Older Living Kidney Donor: Single Centre Experience [abstract]. https://atcmeetingabstracts.com/abstract/the-effect-of-donor-nephrectomy-in-the-older-living-kidney-donor-single-centre-experience/. Accessed December 3, 2024.« Back to 2018 American Transplant Congress