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

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.