Results of Deceased Donor Kidney Transplantation in Young Recipients after Age-matched and Mismatched (Old-to-young) Transplantation

Open access


Introduction. During the previous years the number of organ transplantations from elderly donors increased, and lack of young donors leads to necessity to allocate organs from elderly into young recipients.

Aim of the Study. Was to analyse results of “old-to-young” allocation.

Material and methods. This retrospective study analysed results of all consecutive deceased donor kidney transplantations (DDKT) performed in one transplant centre during the period from 01.01.2004 till 31.12.2007. Patients were selected based on availability of 5-year follow-up and age < 50 years (158 DDKT). Patients were divided into 2 groups according to donor age: age-mismatched group (donor age was > 55 years and at the same time > 15 years older than recipient; n=8, male/female=2/6, age 39,4 + 4,8 years, donor age 59,4 + 2,4 years), and age-matched group (n=150, male/female=88/62, age 36,0 + 11,0 years, donor age 37,3 + 12,0 years). Groups were compared for clinical and demographical features and posttransplant outcomes (delayed graft function, s-creatinin levels at discharge and after 5 years, acute rejection rate, graft and patient 5-year survival).

Results. Comparison of demographical and clinical features revealed only relatively higher BMI in elderly donors (p=0.081) and higher frequency of age-mismatched allocation into female recipients (p=0.066). Early and late post-transplant outcomes showed no significant difference between groups, with similar 5-year graft and patient survival (p=NS for all compared factors).

Conclusion. Results showed good kidney allograft function even in cases of age-mismatched allocation, which is significant opportunity in current situation with increasing age of deceased donors.

1. Maggiore U, Oberbauer R, Pascual J, Viklicky O, Dudley C, Budde K, Sorensen SS, Hazzan M, Klinger M, Abramowicz D. Strategies to increase the donor pool and access to kidney transplantattion: an international perspective // Nephrol Dial Transplant, 2015; 30(2):217-22

2. European Directorate for the Quality of Medicine and HealthCare (EDQM), Council of Europe. Assessment of donors // In: Guide to the quality and safety of organs for transplantation. 5th edition: Council of Europe; 2013; 49-82

3. Remuzzi G, Cravedi P, Perna A, Dimitrov BD, Turturro M, Locatelli G, Rigotti P, Baldan N, Beatini M, Valente U, Scalamogna M, Ruggenenti P. Long-term outcome of renal transplantation from older donors // N Engl J Med 2006; 354: 343-352

4. Meier-Kriesche HU, Kaplan B. Waiting time on dialysis as the strongest modifiable risk factor for renal transplant outcomes: a paired donor kidney analysis // Transplantation 2002; 74(10): 1377-81

5. Veroux M1, Grosso G, Corona D, Mistretta A, Giaquinta A, Giuffrida G, Sinagra N, Veroux P. Age is an important predictor of kidney transplantation outcome // Nephrol Dial Transplant 2012; 27(4): 1663-71

6. Oppenheimer F, Aljama P, Asensio Peinado C, Bustamante Bustamante J, Crespo Albiach JF, Guirado Perich L. The impact of donor age on the results of renal transplantation // Nephrol Dial Transplant. 2004; 19 (3): iii11-5

7. Dempster NJ, Ceresa CDL, Aitken E, Kingsmore D. Outcomes following renal transplantation in older people: a retrospective cohort study // BMS Geriatrics, 2013; 13: 79

8. De Rosa P, Muscogiuri G, Sarno G. Expanded Criteria Donors // in Kidney Transplantation: The Role of Older Donors in a Setting of Older Recipients. ISRN Transplantation; 2013, Article ID 301025, 8 pages.

9. Pierobon ES, Sandrini S, De Fazio N, Rossini G, Fontana I, Boschiero L, Gropuzzo M, Gotti E, Donati D, Minetti E, Gandolfo MT, Brunello A, Libetta C, Secchi A, Chiaramonte S, Rigotti P. Optimizing utilization of kidneys from deceased donors over 60 years: five-year outcomes after implementation of a combined clinical and histological allocation algorithm // Transplant Int 2013; 26(8): 833-41

10. Cohen B, Smits JM, Haase B, Persijn G, Vanrenterghem Y, Frei U. Expanding the donor pool to increase renal transplantation // Nephrol Dial Transplant, 2005; 20: 34-41

11. Aubert O, Kamar N, Vernerey D, Viglietti D, Martinez F, Duong-Van-Huyen JP, Eladari D, Empana JP, Rabant M, Verine J, Rostaing L, Congy N, Guilbeau-Frugier C, Mourad G, Garrigue V, Morelon E, Giral M, Kessler M, Ladrière M, Delahousse M, Glotz D, Legendre C, Jouven X, Lefaucheur C, Loupy A. Long term outcomes of transplantation using kidneys from expanded criteria donors: prospective, population based cohort study // BMJ 2015;351:h3557

Acta Chirurgica Latviensis

The Journal of Riga Stradins University; Latvian Association of Surgeons; Latvian Association of Paediatric Surgeons

Journal Information


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 107 107 11
PDF Downloads 28 28 6