When it comes to kidney transplant recipients with a significantly older living donor, age may just be a number.
In an observational study, a wide age gap between kidney recipient and living donor did not affect graft or patient survival relative to recipients of organs of similar vintage. The results were published in Nephrology Dialysis Transplantation (2011;26:702–708).
Paolo Ferrari, MD, of the Department of Nephrology at Fremantle Hospital in Australia, and colleagues used the Australia and New Zealand Dialysis and Transplant Registry to study all 2,364 primary living-donor kidney transplant recipients in Australia from 1991 to 2006. Of these recipients, 1,495 received a kidney from a donor whose age was greater than theirs.
In the adjusted model, a donorrecipient age difference of 30 years or greater pointed toward an increased risk of graft failure during the first year posttransplant compared with a 10- to 20-year difference.
However, in a multivariate model, donor-recipient age difference was not associated with patient death, death-censored graft failure, or serum creatinine at five or 10 years, nor was it associated with increased risk of acute rejection within the first six months.
In other words, the study showed that living kidney donors who are up to 30 years older than their recipients were able to provide kidneys of excellent quality, which is relevant for paired kidney donation (PKD).
“Expanding the live kidney donorpool with a PKD program should not be limited by unjustified restrictions on the perceived disadvantage of high donor-recipient age difference because this could reduce the chance of finding a suitable match, particularly when the size of the donor-recipient pool is small, unnecessarily increasing the waiting time on dialysis, which is a strong determinant of negative posttransplant graft and patient survival,” Dr. Ferrari and colleagues wrote.