Kidney transplant outcomes from older deceased donors: A paired kidney analysis by the ERA-EDTA Registry

As the median age of deceased kidney donors rises, updated knowledge of transplant outcomes from older deceased donors in differing donor-recipient age groups is required. Using ERA-EDTA Registry data we determined survival outcomes of kidney allografts donated from the same older deceased donor (55-70 years), and transplanted into one recipient younger and one recipient of similar age to the donor. The recipient pairs were divided into two groups: group 1; younger (median age: 52 years) and older (60 years), and group 2; younger (41 years) and older (60 years). 1,410 adults were transplanted during 2000-2007. Compared to the older recipients the mean number of functioning graft years at 10-years was six months longer in the group 1 and group 2 younger recipients (p <0.001). Ten-year graft survival was 54% and 40% for the group 1 younger and older recipients, and 60% and 49% for the group 2 younger and older recipients. Paired Cox regression analyses showed a lower risk of graft failure (group 1 younger; adjusted relative risk [RRa]:0.57, 95%CI:0.41-0.79, and group 2 younger; RRa:0.63, 95%CI:0.47-0.85) in younger recipients. Outcomes from older deceased donor allografts transplanted into differing donor-recipient age groups are better than previously reported. These allografts remain a valuable transplant resource, particularly for similar-aged recipients. This article is protected by copyright. All rights reserved