LIVING-RELATED KIDNEY DONORS OVER 60 YEARS OLD

The lack of available cadaveric organs for transplantation has resulte d in an increased number of kidney transplants from living donors. Dur ing a period of 6 years, 149 kidney transplantations were performed fr om living related donors in our institute, 33.5 % of whom were older t han 60 years of age. In this study we examined the survival of patient s and grafts as well as the graft function in 50 patients with transpl ants from donors over 60 years (mean age 65 years) as compared with th ose of 99 patients with transplants from donors younger than 60 years (mean age 47 years). There were no significant differences in the cour se of donor nephrectomy, postoperative complications, or remnant kidne y function. However, delayed graft function occurred more frequently i n recipients of transplants from older donors. Improvement in graft fu nction was also slower in recipients of kidneys from older donors, wit h significant differences in serum creatinine levels observed during t he first 12 months after transplantation. More frequent acute complica tions and more progressive chronic graft failure, irrespective of the causes, occurred during the 1st post-transplant year in recipients wit h grafts from older donors. Five-year patient survival (77 % vs 92 %) and kidney graft survival differed significantly for the same period w ith worse results for patients receiving grafts from older donors. It may be concluded that kidney grafts from donors older than 60 years - and especially those older than 70 years may be used for living relate d kidney transplantation, but with precautions.