Introduction:

Kidney transplantation from elderly donors is still a very controversial topic. In recent years, we have seen an increase in the number of elderly DCD donors. From all DCD donors in the UK, 35% were older than 60 in 2011.

This reality has had an impact on our practice in Cardiff. Nowadays, we routinely transplant kidneys from elderly DCD donors aged far beyond 70. Therefore we analysed the effect of donor age on the graft function and graft/patient survival.

Method:

Between 1/Jan/2010 and 22/Oct/2012 we transplanted 69 kidneys from DCD donor older than 60 years [44 transplants from donors age 60-69 years (≥60); and 25 transplants from donors more than 70 years old (≥70)]. We compared early outcomes between these two groups.

Results:

The average donor age in ≥60 group was 65.27±2.88 (mean; SD) and 73.77±2.22 (mean; SD) in ≥70 group. There was no difference in recipient age (62.7±8.3 vs. 63.9±7.8, p=0.58), donor creatinine (69.5±20.9 vs. 65.8±11.1, p=0.41) and CIT (12.4±4.4 vs. 13.5±5.1, p=0.38); between ≥60 and ≥70.

We found no difference in incidence of functional DGF, between ≥60 and ≥70 group (84 % vs. 72 %, p=0.23). Also, the glomerular filtration rate after one, three, six, twelve and 24 months was not statistically different between these two groups (≥60 vs. ≥70); 1-month 29.3±13.5 vs.33.7±10.3 p=0.16; 3-months 32.6±12.1 vs. 37.4±10.8, p=0.12; 6-months 36.1±11.9 vs. 37.6±11.0, p=0.64; 1-year 36.2±9.9 vs. 35.6±12.3, p=0.853; 2-years 31.2±7.7 vs. 38.4±19.2, p=0.25). Furthermore, there was similar graft survival in 1 and 2 years.

Conclusion:

The results of our study showed that early outcomes of kidney transplantation from ≥70 DCD donors yielded satisfactory results comparable to kidney transplantation from DCD donors in their 60s. This fact encourages us to increase the kidney transplantation from elderly DCD donors.

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