Midterm Outcome of Aged Donors from Living-Related Donation: analysis of 167 cases at Chinese single center

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Abstract

Background

Kidney transplantation (KT) is the most effective treatment of end-stage renal disease (ESRD). Using grafts from aged donors is increasing worldwide. Our aim was to better understand the safety of aged living donors.

Methods

167 cases (age >55) with living-related kidney donation were analyzed retrospectively. Donor characteristics were summarized. In addition, a questionnaire survey and clinical review, including physical examination and laboratory tests, were performed for each patient. The mean donor estimated glomerular filtration rate (eGFR) was determined using the modification of diet in renal disease formula.

Results

There were no operative death in total 167 cases. The median follow-up period was 5.8 years. One case dead from cerebral vascular accidents 2 years after nephrectomy, and one from liver cancer 4.5 years later. The prevalence of other post-operation comorbidities was 25.7% (n=43) proteinuria, 35.3% (n=59) hypertension, 5.4% (n=9) new-onset diabetes, no case developed end-stage renal disease. Mean eGFR was 81.34∓13.82 before operation and 50.34∓19.39 mL/min/1.73m2 after. The average 24h-TP in cases developed proteinuria was 290∓180mg. All cases can function properly after nephrectomy, 97.6% (n=163) cases were satisfied with the result of status both of themselves and the recipients.

Conclusion

With the current lack of organs, aged living-related donors are an acceptable and safe alternative with a low proportion of other major comorbidities.

References

1. Sapir-Pichhadze R, Young A, Joseph Kim S. Living donor age and kidney transplant outcomes: an assessment of risk across the age continuum. Transplantation International 2013; 26:493–501.

References

2. Naumovic R, Djukanovic L, Marinkovic J, et al. Effect of donor age on the outcome of living-related kidney transplantation. Transplantation International. 2005; 18:1266–74.

References

3. Mjoen G, Hallan S, Hartmann A, et al. Long-term risks for kidney donors. Kidney Int. 2014; 86:162–167.

References

4. Segev DL, Muzaale AD, Ca o BS, et al. Perioperative mortality and long-term survival following live kidney donation. JAMA. 2010; 303:959–966.

References

5. Muzaale AD, Massie AB, Wang MC, et al. Risk of end-stage renal disease following live kidney donation. JAMA. 2014; 311:579–586.

References

6. Ibrahim HN, Foley R, Tan L, et al. Long-term consequences of kidney donation. N Engl J Med. 2009; 360:459–469.

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