Donor Nephrectomy Outcome Research (DONOR) Network Investigators: Neil Boudville, Christine Dipchand, Mona Doshi, Liane Feldman, Amit Garg, Colin Geddes, Eric Gibney, John Gill, Martin Karpinski, Scott Klarenbach, Greg Knoll, Charmaine Lok, Mauricio Monroy-Cuadros, Norman Muirhead, Christopher Y. Nguan, Chirag Parikh, Emilio Poggio, G. V. Ramesh Prasad, Leroy Storsley, Ken Taub, Darin Treleaven, Ann Young
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Accepting Kidneys from Older Living Donors: Impact on Transplant Recipient Outcomes
Article first published online: 14 MAR 2011
DOI: 10.1111/j.1600-6143.2011.03442.x
©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons
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How to Cite
Young, A., Kim, S. J., Speechley, M. R., Huang, A., Knoll, G. A., Prasad, G. V. R., Treleaven, D., Diamant, M., Garg, A. X. and for the Donor Nephrectomy Outcomes Research (DONOR) Network (2011), Accepting Kidneys from Older Living Donors: Impact on Transplant Recipient Outcomes. American Journal of Transplantation, 11: 743–750. doi: 10.1111/j.1600-6143.2011.03442.x
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Donor Nephrectomy Outcome Research (DONOR) Network Investigators: Neil Boudville, Christine Dipchand, Mona Doshi, Liane Feldman, Amit Garg, Colin Geddes, Eric Gibney, John Gill, Martin Karpinski, Scott Klarenbach, Greg Knoll, Charmaine Lok, Mauricio Monroy-Cuadros, Norman Muirhead, Christopher Y. Nguan, Chirag Parikh, Emilio Poggio, G. V. Ramesh Prasad, Leroy Storsley, Ken Taub, Darin Treleaven, Ann Young
Publication History
- Issue published online: 29 MAR 2011
- Article first published online: 14 MAR 2011
- Received 08 September 2010, revised 22 December 2010 and accepted for publication 05 January 2011
Keywords:
- Administrative data;
- cohort study;
- donor age;
- kidney transplant;
- survival analysis
Older living kidney donors are regularly accepted. Better knowledge of recipient outcomes is needed to inform this practice. This retrospective cohort study observed kidney allograft recipients from Ontario, Canada between January 2000 and March 2008. Donors to these recipients were older living (≥60 years), younger living, or standard criteria deceased (SCD). Review of medical records and electronic healthcare data were used to perform survival analysis. Recipients received 73 older living, 1187 younger living and 1400 SCD kidneys. Recipients of older living kidneys were older than recipients of younger living kidneys. Baseline glomerular filtration rate (eGFR) of older kidneys was 13 mL/min per 1.73 m2 lower than younger kidneys. Median follow-up time was 4 years. The primary outcome of total graft loss was not significantly different between older and younger living kidney recipients [adjusted hazard ratio, HR (95%CI): 1.56 (0.98–2.49)]. This hazard ratio was not proportional and increased with time. Associations were not modified by recipient age or donor eGFR. There was no significant difference in total graft loss comparing older living to SCD kidney recipients [HR: 1.29 (0.80–2.08)]. In light of an observed trend towards potential differences beyond 4 years, uncertainty remains, and extended follow-up of this and other cohorts is warranted.