*Purpose: Due to the discrepancy between the number of patients on the waiting list and oragn supply, living donor kidney transplantation is more required. The number of living donors aged 70 and older is gradually increasing. We investigated the safety of living donor kidney transplantation from living donors aged 70 and older.

*Methods: Between January 2008 and December 2018, a total 978 adult living donor kidney transplantations (LDKTs) was performed. A total of 879 LDKTs was included in this study. LDKT was stratified into 2 groups; 769 LDKTs from donors aged less than 70 (LDKT<70) and 110 LDKTs from donors aged 70 and older (LDKT>70). Operative results of donors and recipients, postoperative eGFR of donors and recipients, mortality rate of donors and recipients, graft survival rates, and incidence of end stage renal disease in donors were compared between LDKT<70 and LDKT>70.

*Results: Operative results of donors including warm ischemic time, operation time, blood loss, and incidence of perioperative and postoperative adverse events showed no significant difference. Operative results of recipients including cold ischemic time and incidence of perioperative and postoperative adverse events showed no significant difference. eGFR of donors and recipients in LDKT>70 were significantly lower than those of LDKT<70. The mortality rate of donors and recipients showed no significant difference.

The graft survival rates of LDKT>70 showed significantly lower than that of LDKT<70 (P = 0.006).

End stage renal disease of donors was not identified in both LDKT<70 and LDKT>70.

*Conclusions: LDKT from donors aged 70 and older was demonstrated to be a safe operation although graft loss rate in donors aged 70 and older was significantly higher than that in donors aged less than 70.

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