Results Of Renal Transplantation From The Very Elderly Deceased Donors: An Age-Based View

Objective: Geriatric donors may be associated with worse allograft quality and less survival rates. We report the outcomes of allografts harvested from geriatric deceased donors and the survival rates of the recipients.Methods: In this study, 284 deceased donors and their recipients were enrolled in the study. Donors and recipients were divided into 3 groups according to the World Health Organisation age classification: child (<18 years), adult (>= 18 and <65 years), and geriatric (>= 65 years). The geriatric group was divided into the elderly (>= 65 and <75 years) and very elderly (>= 75 years) groups. Short- and long-term survival of the allografts and recipients and factors might have an impact on those were investigated.Results: 284 recipients were followed-up median of 55 months (0-143), in which 52 recipients died and the median allograft survival was 49 months (0-143). In the geriatric donor group, the average allograft survival rate was less compared to other age groups. However, the elderly donor and very elderly groups have a similar 1-, 3-, and 5-year allograft survival rate. One-year allograft survival rate was similar among all age groups, however, less at third and fifth years post-transplant, in the elderly and very elderly groups. One-, 3-, and 5-year recipient survival rates were similar among all age groups. However, in subgroup analysis, in the very elderly group, the 5-year recipient survival rate was the worst.Conclusion: One-year allograft survival rates are similar among all age groups. However, allograft loss becomes apparent at 3- and 5-year post-transplant in geriatric donors. Short- and long-term outcomes of allografts from the elderly and very elderly deceased donors are similar. When considering a kidney allograft transplantation from geriatric donors, the inverse impacts of donors' age should be considered in matching donors and recipients. Nevertheless, clinicians should not hesitate to transplant an allograft from a very elderly deceased donor to a recipient candidate considering the worse outcomes of dialysis modalities.