Kidney transplantation using elderly non-heart-beating donors: a single-center experience

M.G. Snoeijs, S. Schaefer, M.H. Christiaans, J.P. van Hooff, E.M. van den Berg-Loonen, C.J. Peutz-Kootstra, W.A. Buurman, L.W.E. van Heurn*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Although acceptable outcomes have been reported in both non-heart-beating (NHB) and elderly donors individually, the large pool of elderly NHB donors has not yet been fully utilized. In 1994, we expanded our transplant protocol to include NHB donors aged over 65 years and this study compares the clinical outcomes with regular NHB transplantations. Up to June 2005, 24 patients were transplanted at our center with kidneys from NHB donors aged 65 years or more, whereas 176 patients received grafts from conventional NHB donors during the same period. Grafts from older donors were associated with inferior glomerular filtration rates (29 vs. 44 mL/min after 1 year, p=0.01) and graft survival (52% vs. 68% after 5 years, p=0.19) compared to younger NHB donor grafts, although the difference in graft survival was not statistically significant. Exclusion of older NHB donor kidneys with severe vascular pathology resulted in similar graft survival of older and younger NHB donor kidneys. We conclude that the use of elderly NHB donors in order to expand the donor pool was associated with unacceptable clinical outcomes and cannot be justified without further refinement in their selection, for example, by histological assessment of pretransplant biopsies.
Original languageEnglish
Pages (from-to)1066-1071
JournalAmerican Journal of Transplantation
Volume6
Issue number5 Pt 1
DOIs
Publication statusPublished - 1 Jan 2006

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