Old age should not exclude organ donation after death

Highlights

• In a recent study, patient and organ survival rates were similar following transplantation using kidneys from donors aged 50-59 years, 60-69 years, 70-79 years, and ?80 years.
• Kidney discard rates were similar for kidneys from donors aged 50 to 79 years, but the rate was strikingly higher among kidneys from octogenarian donors.
• The donor organ shortage is the most pressing problem facing kidney transplantation.

Washington, DC (December 15, 2016) -- New research suggests that age cut-offs for deceased organ donors prevent quality kidneys from being available to patients in need of life-saving transplants. A study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN) found that even kidneys from donors ?80 years of age can function for years after transplantation.

Older donor age is a common reason for refusing to use a kidney for transplantation, but the donor organ shortage has led to recent efforts to find ways to include older deceased donor kidneys. To see how donor age affects the long-term functioning of transplanted kidneys, Luigi Biancone, MD (University of Torino, in Italy) and his colleagues analyzed information on deceased donor kidney transplants performed at the Turin University Renal Transplant Center from 2003 through 2013. The researchers identified a total of 647 transplants from so-called "extended criteria" donors, which were defined as all donors >60 years and those aged 50 to 59 years with certain risk factors.

After a median follow-up of 4.9 years, patient and kidney survival were comparable among age groups (50-59 years, 60-69 years, 70-79 years, and ?80 years). The 5-year patient survival rates ranged from 87.8% to 90.1%, and the 5-year kidney survival rates ranged from 65.9% to 75.2%. Rates of kidney discard before transplantation were similar for kidneys from donors aged 50 to 79 years, but the discard rate was strikingly higher among kidneys from octogenarian donors.

"The results of this study support the use of extended criteria donors, even donors older than 80 years, but they have to be accurately selected and managed with dedicated protocols," said Dr. Biancone.

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Study co-authors include Maria Messina, MD, Davide Diena, MD, Sergio Dellepiane, MD, PhD, Gabriella Guzzo, MD, Luca Lo Sardo, Fabrizio Fop, Giuseppe Segoloni, Antonio Amoroso, and Paola Magistroni.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Long-term Outcomes and Discard Rate of Kidneys by Decade of Extended Criteria Donor Age," will appear online at http://cjasn.asnjournals.org/ on December 15, 2016, doi: 10.2215/CJN.05990616.

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