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. 2024 Jun 20;10(7):e1660.
doi: 10.1097/TXD.0000000000001660. eCollection 2024 Jul.

Long-term Outcomes After Kidney Transplantation From DBD Donors Aged 70 y and Older

Jørn Petter Lindahl  1 , Anders Åsberg  1   2 , Kristian Heldal  1   3 , Trond Jenssen  1   4 , Christina Dörje  1 , Morten Skauby  5 , Karsten Midtvedt  1
Affiliations

Long-term Outcomes After Kidney Transplantation From DBD Donors Aged 70 y and Older

Jørn Petter Lindahl et al. Transplant Direct. .

Abstract

Background: Transplantation of kidneys from elderly donations after brain death (DBD) donors has increased owing to organ shortages. We aimed to assess the impact on long-term kidney transplant outcomes from DBD donors aged 70 y and older compared with kidneys from younger donors.

Methods: From 2007 to 2022, 2274 first single kidney transplantations from DBD donors were performed at our center. Data from 1417 kidney transplant recipients receiving a DBD organ were included and categorized into 3 groups according to donor age: 70 y and older (n = 444, median age 74 y), 60-69 y (n = 527, median age 64 y), and a reference group consisting of donors aged 45-54 y (n = 446, median age 50 y). Kaplan-Meier plots and multivariate Cox regression with correction for recipient, donor, and transplant characteristics were used to investigate patient and kidney graft survival outcomes.

Results: The median patient follow-up time was 9.3 y (interquartile range, 5.3-13.1). The adjusted hazard ratios for patient death in recipients of kidneys from DBD donors aged 70 y and older compared with 60-69 y and 45-54 y were 1.12 (95% confidence interval [CI], 0.92-1.36; P = 0.26) and 1.62 (95% CI, 1.26-2.07; P < 0.001), respectively. Compared with recipients of donors aged 60-69 y and 45-54 y, the adjusted hazard ratios for kidney graft loss in recipients of donors aged 70 y and older were 1.23 (95% CI, 1.02-1.48; P = 0.029) and 1.94 (95% CI, 1.54-2.45; P < 0.001), respectively.

Conclusions: Transplantation of kidneys from DBD donors aged 70 y and older resulted in acceptable long-term outcomes and is encouraging.

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Conflict of interest statement

The authors declare no funding or conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
The proportions (%) of DDs aged 70 y and older increased from 2007 to 2022 in the investigated donor groups. DD, deceased donor.
FIGURE 2.
FIGURE 2.
Kaplan-Meier probability estimates of patient survival, grouped by donor age (P < 0.001). Donors aged 45–54 y, solid line; 60–69 y, dashed line; and 70 y and older, dotted line.
FIGURE 3.
FIGURE 3.
Kaplan-Meier probability estimates of kidney graft survival, grouped by donor age (P < 0.001). Donors aged 45–54 y, solid line; 60–69 y, dashed line; and 70 y and older, dotted line.
FIGURE 4.
FIGURE 4.
Kaplan-Meier probability estimates of death-censored kidney graft survival, grouped by donor age (P < 0.001). Donors aged 45–54 y, solid line; 60–69 y, dashed line; and 70 y and older, dotted line.
See this image and copyright information in PMC

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