Foss, A. et al. Kidneys from deceased donors more than 75 years perform acceptably after transplantation. Transplantation 87, 1437–1441 (2009).

Collini, A. et al. Renal transplant from very old donors: how far can we go? Transplantation 87, 1830–1836 (2009).

Kidneys from deceased donors aged over 75 years, which are often discarded solely due to the donor's advanced age, should be considered for older recipients, according to results from two studies published in Transplantation.

...overall patient and graft survival [with kidneys from older donors] is acceptable

“Because of a rising incidence of end-stage renal disease there is a growing discrepancy between availability of and the need for donor kidneys,” states Aksel Foss, lead author of one of the studies. Extending the selection criteria to include older donors could increase the number of available transplants. Although survival of kidney grafts from older donors is worse than that of kidneys from younger donors, kidneys from older donors might still improve the quality of life of patients on waiting lists for kidney transplantation.

Foss and colleagues assessed the outcomes of single kidney transplants donated to 54 recipients (median age 70.1 years) from 29 donors (median age 77.5 years). Patient survival rates at 1, 3 and 5 years were 81%, 75% and 59%, respectively, and graft survival rates at these time points were 77%, 72% and 59%. These survival rates were not significantly different to those of a control group of 154 renal transplants from extended criteria donors aged <75 years. “The results indicate that the overall patient and graft survival [with kidneys from older donors] is acceptable,” says Foss. He goes on to explain that although several kidneys had severe age-related histopathological changes, all showed satisfactory long-term function.

In the other study, Andrea Collini's team evaluated data on grafts from 60 deceased donors (median age 78 years) given to 38 recipients (median age 62 years), 16 as single and 22 as double transplants. Patient survival rate was 81.2% at 1 year and remained stable over 3 years. Graft survival rates were 73.7%, 69.8% and 64.0% at 1, 2 and 3 years, respectively.

“Age and histopathological findings alone do not seem to be sufficient to determine whether or not a kidney should be used for transplantation,” states Foss. “Further research on criteria for the optimal use and evaluation of extended criteria donors is extremely important.”