Background: Organ shortage has resulted in an increased use of expanded criteria donors for transplantation, in particular kidneys from older donors. There is limited data on the impact of donor age more than 75 years on kidney transplant outcome.
Methods: A retrospective single-center analysis on deceased donors more than 75 years and kidney transplant outcome in an old for old setting was performed. Histologic findings (global kidney score) in graft biopsies and deceased-donor scores were evaluated to observe if this information could be helpful in predicting outcome.
Results: Evaluation of data from 54 single kidney transplantations from 29 donors more than 75 years (median 77.5, range 75.2-86.1) were assessed. Ninety-three percent of the donors died of intracranial bleeding, and 69% had a history of hypertension or cardiovascular event(s). Median recipient age was 70.1 (range 50.6-82.4). Fifty-two grafts (96%) had posttransplant function. Death censored graft survival at 1, 3, and 5 years were 87%, 83%, and 83%, respectively. Patient survival was 81%, 75%, and 59% at the same time points. At follow-up at median 23 months (range 6-144 months), thirty-five recipients were alive with a median serum creatinine of 163 micromol/ L (range 103-348). Global kidney score and deceased donor score did not predict graft outcome.
Conclusion: Kidney transplants from deceased donors more than 75 years perform acceptable as single transplants and should be considered for use in older recipients.