Old-for-Old Age Matching in Living Donor Kidney Transplantation: A Single-Center Experience
Takuzo Fujiwara1*, Shinichiro Tanaka1, Kei Namba1, Haruchika Yamamoto1, Shoma Teruta1, Nozomi Morikawa1, Shimpei Tsudaka1 and Hiroaki Matsuda2
1Department of Surgery, National Hospital Organization Okayama Medical Center, Okayama, Japan
2Department of Surgery, Saiwaicho Memorial Hospital, Okayama, Japan
- *Corresponding Author:
- Takuzo Fujiwara
Department of Surgery
National Hospital Organization Okayama Medical Center
1711-1 Tamasu, Kita-ku, Okayama 701-1192, Japan
E-mail: [email protected]
Received Date: September 19, 2014; Accepted Date: October 21, 2014; Published Date: October 23, 2014
Citation: Fujiwara T, Tanaka S, Namba K, Yamamoto H, Teruta S, et al. (2014) Old-for-Old Age Matching in Living Donor Kidney Transplantation: A Single-Center Experience. J Transplant Technol Res 4: 141. doi: 10.4172/2161-0991.1000141
Copyright: © 2014 Fujiwara T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The impact of donor age, especially from older donors (≥ 60 years), on recipient outcomes in living donor kidney transplantation were retrospectively evaluated in 181 consecutive primary kidney transplant recipients. Patients were categorized according to donor age: age ≤ 39 (n=15), 40Ã¢ÂÂ49 (n=28), 50Ã¢ÂÂ59 (n=71), and ≥ 60 years (n=67). Cox proportional hazard multivariate analysis was used to calculate the relative risk of patient and graft survival. Cox analysis showed that donor age, as a continuous variable, was not a risk factor for patient or graft survival. Deathuncensored (65.4%) and censored (73.1%) graft survival rates in the oldest donor group were lowest, although the differences did not reach statistical significance (p=0.086 and 0.127, respectively). Mean estimated glomerular filtration rates one year after transplantation in these 4 groups were 63.1 ± 13.9, 60.4 ± 18.5, 49.2 ± 15.4 and 42.6 ± 11.4 ml/ min/1.73 m2, respectively (p < 0.001). Subdivision by age of recipients of kidney donors ≥ 60 years into those aged, ≤ 39, (n=31), 40-59, (n=25) and ≥ 60 (n=11) years, showed optimal results in old for old combination transplants. The death-uncensored graft survival rates in the 3 subgroups were 64.5%, 76.0% and 90.9%, respectively (p=0.869), whereas their mean estimated glomerular filtration rates 1 year after transplantation were 40.7 ± 7.4, 41.0 ± 10.7 and 51.4 ± 14.3 ml/min/1.73 m2, respectively (p=0.025). Age-matching may be beneficial when performing living donor kidney transplantation from older donors.