Kidney Transplants Okay From Older Donors

Kidney transplants from donors older than 60 years of age can have a good outcome, providing the grafts are evaluated prior to implantation, according to a new study.

Researchers compared the outcomes of 62 patients given histologically evaluated kidneys from older donors with those of 248 matched recipients given non-evaluated kidneys from either older or younger donors. All of the recipients were older than 50 years of age.
The kidneys were histologically evaluated and scored for a global rating of 0-12. Kidneys with a score of zero to three were used in single transplants, those scoring four to six were earmarked for dual transplants, and those rated seven or worse were discarded.

During a median follow-up period of 23 months, the rate of progression to dialysis was 6% in the group given evaluated grafts from older donors, 7% among recipients of kidneys from younger donors, and 23% among recipients of non-evaluated kidneys from older donors. Using an evaluated graft from an older donor, rather than a non-evaluated one, cut the risk of graft failure by 3.68-fold. The findings were published in the January 26, 2006, edition of The New England Journal of Medicine.

In both the overall and older donor group analysis, preimplantation histologic assessment of grafts was associated with significantly improved survival, noted Dr. Piero Ruggenenti, from the Mario Negri Institute for Pharmacological Research (Bergamo, Italy), and colleagues, who conducted the study.

The researchers concluded that the long-term survival of single or dual kidney grafts from donors older than 60 years of age is excellent, provided that the grafts are evaluated histologically before implantation. This approach could help to expand the donor-organ pool for kidney transplantation.



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