Living Kidney Donors: Impact of Age on Long‐Term Safety

• Published in: American journal of transplantation Vol. 11; no. 4; pp. 737 - 742
• Main Authors: Dols, L. F. C., Kok, N. F. M., Roodnat, J. I., Tran, T. C. K., Terkivatan, T., Zuidema, W. C., Weimar, W., IJzermans, J. N. M.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.04.2011; Wiley
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Blood pressure; Digestive system. Abdomen; Endoscopy; Female; Follow-Up Studies; Glomerular Filtration Rate; Graft Survival; Humans; Investigative techniques, diagnostic techniques (general aspects); Kidney - physiopathology; Kidney - surgery; kidney function; Kidney Function Tests; kidney transplantation; Kidney Transplantation - mortality; laparoscopic donor nephrectomy; live donors; Living Donors; Male; Medical sciences; Middle Aged; older donors; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Young Adult; Suboptimal donor; Renal function; Toxicity; Homotransplantation; Kidney; Nephrectomy; Surgery; Graft; Complication; Arterial pressure; Blood pressure; Endoscopy; Safety; Age; Endoscopic surgery; kidney function; Living donor; Laparoscopy; laparoscopic donor nephrectomy; older donors; Long term; Treatment; Urinary system; live donors; Hemodynamics; Organ harvesting; Kidney transplantation
• DOI: 10.1111/j.1600-6143.2011.03465.x
• ISSN: 1600-6135

The safety of older live kidney donors, especially the decline in glomerular filtration rate (GFR) after donation, has been debated. In this study we evaluated long‐term renal outcome in older live kidney donors. From 1994 to 2006 follow‐up data of 539 consecutive live kidney donations were prospectively collected, during yearly visits to the outpatient clinic. Donors were categorized into two groups, based on age: <60 (n = 422) and ≥60 (n = 117). Elderly had lower GFR predonation (80 vs. 96 mL/min respectively, p < 0.001). During median follow‐up of 5.5 years, maximum decline in eGFR was 38%± 9% and the percentage maximum decline was not different in both groups. On long‐term follow‐up, significantly more elderly had an eGFR <60 mL/min (131 (80%) vs. 94 (31%), p < 0.001). However, renal function was stable and no eGFR of less than 30 mL/min was seen. In multivariate analysis higher body mass index (HR 1.09, 95%CI 1.03–1.14) and more HLA mismatches (HR 1.17, 95%CI 1.03–1.34) were significantly correlated with worse graft survival. Donor age did not influence graft survival. After kidney donation decline in eGFR is similar in younger and older donors. As kidney function does not progressively decline, live kidney donation by elderly is considered safe. Live kidney donation by the elderly is considered, demonstrating that the decline in eGFR is similar in younger and older donors.