Selected Older Kidneys Match Younger Organs for Transplant
Italian study finds histologically evaluated 70-year-old kidneys function as well as those a decade younger
WEDNESDAY, April 1 (HealthDay News) -- Carefully selected kidneys transplanted from donors aged 70 or older can produce outcomes similar to organs from donors 60 to 69 years old, according to a letter in the April 2 issue of the New England Journal of Medicine.
Paolo Rigotti, M.D., of the University of Padua in Italy, and colleagues compared the outcomes of transplants between 2000 and 2006, including 71 recipients who received kidneys from donors aged 70 or older and 67 recipients who received kidneys from donors aged 60 to 69. Before transplant, the kidneys provided by the older donors were histologically evaluated for changes in vessels, glomeruli, tubules and connective tissues, and were rated. When both kidneys scored 0 to 3, each was used in a different recipient; when one scored 0 to 3 and the other 4 to 6, or when both scored 4 to 6, both were used in the same recipient; if one kidney scored 4 to 6 and the other 7 or greater, they were not used.
Recipients of the older kidneys spent a shorter time waiting and received a dual transplant more often than those receiving younger kidneys (78 percent versus 28 percent), the authors note. At 24 months, five patients receiving older kidneys and six patients receiving younger kidneys either died or required dialysis. Graft survival, renal function, proteinuria and adverse events were similar in both groups, the researchers found.
"With this approach, selection criteria might be extended to increase the number of available transplants without increasing the risk of premature graft failure among recipients of kidneys from older donors," Rigotti and colleagues conclude.