PURPOSE: Donation after circulatory death (DCD) renal allografts are associated with excellent outcomes.
We performed a retrospective chart review to investigate the impact of donor age on post-operative and intermediate-term outcomes.
MATERIALS & METHODS: We compared recipient outcomes of DCD allografts from donors >50 years of age to those < 50 years. Between July 2006 and September 2013, our institution performed 118 single DCD renal transplants. Outcome variables (creatinine clearance (CrCl)), readmission rate, length of hospital stay (LOS), delayed graft function (DGF), graft loss and rejection) were compared between the two age categories using Student's t-test and Pearson chi-square test. Independent prognosticators of CrCl at 12 months were assessed with multivariate linear regression modeling.
RESULTS: Mean recipient age was 53.8±14.7 years and 45.8% of DCD donors were >50 years of age. Median follow-up was 21 months (range 1 to 87). Recipients of kidney transplants from DCD donors >50 years of age demonstrated lower CrCl at 1 month (50.3±25.3 mL/min vs. 72.7±31.7 mL/min, p< 0.001), 3 months (62.5±22.9 mL/min vs 87.9±36.4 ml/min, p< 0.001), and 1 year (66.2±26.8 mL/min vs 87.8±38.7 mL/min, p=0.013). However, the two groups did not differ with regard to DGF, graft loss, hospital readmissions, or LOS. Multivariate linear regression demonstrated that donor age, recipient age, recipient sex, and cold ischemia time were independent predictors of CrCl at 12 months.
CONCLUSION: Recipients of allografts from donors >50 years of age demonstrated inferior renal function at 1 year, but both groups had similar graft survival and short-term outcomes. Longer follow-up is required to determine long-term allograft survival.
Written by:
Huynh MJ, Violette PD, Rowe NE, Weernink C, Maclean K, Sener A, Luke PP. Are you the author?
St. Joseph's Health Care, London, 268 Grosvenor Street, Room B4-657, London, Ontario, Canada, N6A 4V2; 5991 Spring Garden Road, Suite 620, Halifax, NS, B3H 1Y6; London Health Sciences Centre, 339 Windermere Road, London, Ontario, N6A 5A5.
Reference: J Urol. 2015 May 13. pii: S0022-5347(15)03943-9.
doi: 10.1016/j.juro.2015.04.110
PubMed Abstract
PMID: 25981804