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Outcomes in kidney transplant recipients from older living donors.

Publication ,  Journal Article
Englum, BR; Schechter, MA; Irish, WD; Ravindra, KV; Vikraman, DS; Sanoff, SL; Ellis, MJ; Sudan, DL; Patel, UD
Published in: Transplantation
February 2015

BACKGROUND: Previous studies demonstrate that graft survival from older living kidney donors (LD; age>60 years) is worse than younger LD but similar to deceased standard criteria donors (SCD). Limited sample size has precluded more detailed analyses of transplants from older LD. METHODS: Using the United Network for Organ Sharing database from 1994 to 2012, recipients were categorized by donor status: SCD, expanded criteria donor (ECD), or LD (by donor age: <60, 60-64, 65-69, ≥70 years). Adjusted models, controlling for donor and recipient risk factors, evaluated graft and recipient survivals. RESULTS: Of 250,827 kidney transplants during the study period, 92,646 were LD kidneys, with 4.5% of these recipients (n=4,186) transplanted with older LD kidneys. The use of LD donors 60 years or older increased significantly from 3.6% in 1994 to 7.4% in 2011. Transplant recipients with older LD kidneys had significantly lower graft and overall survival compared to younger LD recipients. Compared to SCD recipients, graft survival was decreased in recipients with LD 70 years or older, but overall survival was similar. Older LD kidney recipients had better graft and overall survival than ECD recipients. CONCLUSIONS: As use of older kidney donors increases, overall survival among kidney transplant recipients from older living donors was similar to or better than SCD recipients, better than ECD recipients, but worse than younger LD recipients. With increasing kidney donation from older adults to alleviate profound organ shortages, the use of older kidney donors appears to be an equivalent or beneficial alternative to awaiting deceased donor kidneys.

Duke Scholars

Published In

Transplantation

DOI

EISSN

1534-6080

Publication Date

February 2015

Volume

99

Issue

2

Start / End Page

309 / 315

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Treatment Outcome
  • Transplant Recipients
  • Time Factors
  • Surgery
  • Risk Factors
  • Middle Aged
  • Male
  • Living Donors
 

Citation

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Englum, B. R., Schechter, M. A., Irish, W. D., Ravindra, K. V., Vikraman, D. S., Sanoff, S. L., … Patel, U. D. (2015). Outcomes in kidney transplant recipients from older living donors. Transplantation, 99(2), 309–315. https://doi.org/10.1097/TP.0000000000000607
Englum, Brian R., Matthew A. Schechter, William D. Irish, Kadiyala V. Ravindra, Deepak S. Vikraman, Scott L. Sanoff, Matthew J. Ellis, Debra L. Sudan, and Uptal D. Patel. “Outcomes in kidney transplant recipients from older living donors.Transplantation 99, no. 2 (February 2015): 309–15. https://doi.org/10.1097/TP.0000000000000607.
Englum BR, Schechter MA, Irish WD, Ravindra KV, Vikraman DS, Sanoff SL, et al. Outcomes in kidney transplant recipients from older living donors. Transplantation. 2015 Feb;99(2):309–15.
Englum, Brian R., et al. “Outcomes in kidney transplant recipients from older living donors.Transplantation, vol. 99, no. 2, Feb. 2015, pp. 309–15. Pubmed, doi:10.1097/TP.0000000000000607.
Englum BR, Schechter MA, Irish WD, Ravindra KV, Vikraman DS, Sanoff SL, Ellis MJ, Sudan DL, Patel UD. Outcomes in kidney transplant recipients from older living donors. Transplantation. 2015 Feb;99(2):309–315.

Published In

Transplantation

DOI

EISSN

1534-6080

Publication Date

February 2015

Volume

99

Issue

2

Start / End Page

309 / 315

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Treatment Outcome
  • Transplant Recipients
  • Time Factors
  • Surgery
  • Risk Factors
  • Middle Aged
  • Male
  • Living Donors