Results of Deceased Donor Kidney Transplantation in Young Recipients after Age-matched and Mismatched (Old-to-young) Transplantation

Summary
Introduction. During the previous years the number of organ transplantations from elderly donors increased, and lack of young
donors leads to necessity to allocate organs from elderly into young recipients.
Aim of the Study. Was to analyse results of “old-to-young” allocation.
Material and methods. Th is retrospective study analysed results of all consecutive deceased donor kidney transplantations (DDKT)
performed in one transplant centre during the period from 01.01.2004 till 31.12.2007. Patients were selected based on availability
of 5-year follow-up and age < 50 years (158 DDKT). Patients were divided into 2 groups according to donor age: age-mismatched
group (donor age was > 55 years and at the same time > 15 years older than recipient; n=8, male/female=2/6, age 39,4 + 4,8
years, donor age 59,4 + 2,4 years), and age-matched group (n=150, male/female=88/62, age 36,0 + 11,0 years, donor age 37,3 +
12,0 years). Groups were compared for clinical and demographical features and posttransplant outcomes (delayed graft function,
s-creatinin levels at discharge and after 5 years, acute rejection rate, graft and patient 5-year survival).
Results. Comparison of demographical and clinical features revealed only relatively higher BMI in elderly donors (p=0.081) and
higher frequency of age-mismatched allocation into female recipients (p=0.066). Early and late post-transplant outcomes showed
no significant difference between groups, with similar 5-year graft and patient survival (p=NS for all compared factors).
Conclusion. Results showed good kidney allograft function even in cases of age-mismatched allocation, which is significant
opportunity in current situation with increasing age of deceased donors.