CLINICAL AND ETHICAL ASPECTS OF LIVING DONOR TRANSPLANTATION

M. Laging¹, J.A. Kal-van gestel², J.N. Ijzermans³, W. Weimar^4
1Kidney Transplantation, D-408, Erasmus Medical Center, Rotterdam/NETHERLANDS, ², Erasmus Medical Center, Rotterdam/NETHERLANDS, ³Surgery, Erasmus Medical Center, Rotterdam/NETHERLANDS, ⁴Kidney Transplantation, Room D-408, Erasmus Medical Center, Rotterdam/NETHERLANDS

Body: Introduction: To expand the kidney donor pool, more and more older deceased and living donors (DD and LD) were accepted over the years. We wondered whether donor age had influenced graft survival. Methods: In our centre 2469 kidneys were transplanted into 2001 patients from 1971 to 2010. There were 1550 kidneys derived from DD and 919 from LD. We performed life table survival analyses using SPSS to obtain uncensored, graft and patient survival over a period of 15 years. We analyzed donor age and donor type. Donor age was stratified in 20-years blocks. Older age was defined as >60 years. Results: Kidneys from older (>60y) DD had a graft survival of 64% at 5 years, 49% at 10 years, and 42% at 15 years. Median graft survival of older DD kidneys was significantly (p<0.001) shorter compared to kidneys from the younger age groups. Kidneys from older (>60y) LD had a graft survival of 86% at 5 years, 72% at 10 years, and 67% at 15 years. There was no difference in graft survival of the LD kidneys between the various age groups. We found a 7.5-year better median uncensored survival for older LD kidneys compared to older DD kidneys, while there was no difference in recipient age (p=0.219). Conclusion: Graft survival of older LD kidneys is superior to that of older DD kidneys. Older age significantly affected graft survival of DD, but not that of LD kidneys.

Disclosure: All authors have declared no conflicts of interest.