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. 2023 Mar;41(3):695-707.
doi: 10.1007/s00345-023-04311-4. Epub 2023 Mar 13.

Kidney transplantation from elderly donors (> 70 years): a systematic review

Benoit Mesnard #  1 , Angelo Territo #  2 , Riccardo Campi  3 , Vital Hevia  4 , Iulia Andras  5 , Alberto Piana  6 , Alessio Pecoraro  3 , Romain Boissier  7 , Thomas Prudhomme  8 ; EAU-Young Academic Urologist (YAU) group of Kidney Transplantation
Collaborators, Affiliations

Kidney transplantation from elderly donors (> 70 years): a systematic review

Benoit Mesnard et al. World J Urol. 2023 Mar.

Abstract

Purpose: The incidence of kidney transplants from elderly donors over 70 years of age has increased significantly over the past 10 years to reach 20% of available kidney graft in some European countries. However, there is little data available on the outcomes of transplants from these donors. We performed a systematic review to evaluate the outcomes of transplantation from donors over 70 years of age.

Methods: A systematic review was performed according to preferred reporting items for systematic reviews and meta-analyses. Medline, Embase, and Cochrane databases were searched to identify all studies reporting outcomes on kidney transplants from donors over 70 years. Due to the heterogeneity of the studies, a meta-analysis could not be performed.

Results: A total of 29,765 patients in 27 studies were included. The mean donors age was 74.79 years, and proportion of kidney graft from women was 53.54%. The estimated 1- and 5-year kidney death-censored graft survivals from donors > 70 years old were, respectively, 85.95 and 80.27%, and the patient survivals were 90.88 and 71.29%. The occurrence of delayed graft function was 41.75%, and primary non-function was 4.67%. Estimated graft function at 1 and 5 years was 36 and 38 mL/min/1.73 m2. Paucity data were available on post-operative complications.

Conclusions: Elderly donors appear to be a reliable source of grafts. However, these transplants are associated with a high rate of delayed graft function without repercussion on long-term graft survival. Allocation strategy to elderly recipients is the main factor of decreased recipient survival.

Keywords: Aged, 70 and over; Donor selection; Graft survival; Kidney transplantation.

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