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Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly
Author(s) -
Serrano Oscar K.,
Yadav Kunal,
Bangdiwala Ananta,
Vock David M.,
Dunn Ty B.,
Finger Erik B.,
Pruett Timothy L.,
Matas Arthur J.,
Kandaswamy Raja
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13287
Subject(s) - medicine , contraindication , nephrectomy , renal function , perioperative , ileus , surgery , kidney disease , univariate analysis , blood pressure , donation , kidney , multivariate analysis , urology , alternative medicine , pathology , economics , economic growth
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.