LIVING KIDNEY TRANSPLANTATION FROM DONORS OVER SIXTY AND ITS RESULTS IN THE LATE FOLLOW-UP

Abstract

THE AIM of the investigation was to assess longterm outcomes (loss of transplant and its function) of transplantation of the kidneys from elderly (≥ 60 years) donors and compare them to a control group of donors <60 years. PATIENTS AND METHODS. Results of 154 renal transplantations from living related and nonrelated (spouses) donors performed between 1992 and May 2002 were analyzed. All patients were divided into two groups according to the donors’ age: group 1 (n=44) mean age of donor 66.4±4.9 (6078) years and group 2 (control group, n=110) mean age of donors 47.9±7.9 (2259) years. The maintenance immunosuppression consisted of cyclosporine, azathioprine or mofetil mycophenolate and prednisolone. The graft function was evaluated by serum creatinine concentration levels. The χ 2  test was used to compare differences between the groups. RESULTS. Transplants from elderly donors made up 28.6% of all living donor transplants. Mean age of the recipients (36.6±9.4 vs 30.2±11.4), percentage of retransplanted patients (4.5% vs 6.4%), HLA match (3.59 vs 3.1), number of sensitizated (PRA ≥ 50%) patients (6.8% vs 3.6%) were similar in both groups. In group 1 37 patients and 96 patients from group 2 were followed up for a year after transplantation. No statistically significant differences in the patients’ state and graft loss were found during the first year. The percentage of recipients with excellent and good graft function in group 1 was statistically significantly lower than in group 2: 81.1% vs 93.8% (χ2 =4.8604 p<0.05) in a year, 73.0% vs 89.6% (χ2 =5.5124 , p< 0.02) in 3 years and 50.0% vs 93.2% (χ2 = 15.3014, p<0.001) in 5 years respectively. CONCLUSION. The risk of chronic rejection of the transplanted kidney is independent of the donor’s age. Excellent and good state of the graft from elderly donors was observed more rarely than of the graft from younger donors.