Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly

作者：Serrano Oscar K^*; Yadav Kunal; Bangdiwala Ananta; Vock David M; Dunn Ty B; Finger Erik B; Pruett Timothy L; Matas Arthur J; Kandaswamy Raja

来源：Clinical Transplantation, 2018, 32(8): e13287.

DOI：10.1111/ctr.13287

• donor nephrectomy
• elderly
• living donor kidney transplant

With increasing organ demand, living kidney donation from older donors (>60-years-old) has become more common. Between 1975 and 2014, 3752 donor nephrectomies (DN) were performed at University of Minnesota; 167 (4.5%) were >60-years-old Short- and long-term outcomes were compared between contemporaneous >60-years-old and <60-years-old donors. On univariate analysis, >60-years-old were more likely to have had prior abdominal surgery and hypertension; and less likely to smoke. Baseline estimated glomerular filtration rate (eGFR) was lower in >60-years-old (80 +/- 16 vs 101 +/- 26 mL/min/1.73 m(2); P < .001). Intraoperative and postoperative complications were similar, except a higher prevalence of <30 day ileus (3% vs 7%; P = .021) and longer postoperative length of stay (LOS) (4.2 vs 4.6 days; P = .005). On multivariate analysis, <30 day ileus and LOS continued to be significantly greater for >60-years-old After >20 years post-DN, systolic blood pressure was significantly higher among >60-years-old (142 vs 125 mm Hg; P < .001) and HTN was diagnosed earlier (9 vs 14 years). After donation, eGFR was significantly lower for >60-years-old but slope of eGFR and rates of end-stage renal disease (ESRD) were not significantly different >20 years post-DN. Thus, kidney donation among carefully selected >60-years-old poses minimal perioperative risks and no added risk of long-term ESRD.

• 出版日期2018-8