Is there a limiting age for organ donation?

Nowadays organ transplantations suffer from a lack of donors. Thus the wait ing list of patients is constantly growing. Several ways to increase organ procurement are being evaluated. About 50% of cerebral deaths are related t o vascular cerebral in patients older than 60 years. For the last few years , organs have been harvested from these patients despite their age. As the quality of the grafts is reduced, transplantation of one kidney may be insu fficient whilst transplantation of the two kidneys to the same recipient is technically possible. We report here a case of a 44-year-old patient who was transplanted with tw o kidneys in September 2000. The donor was 85-year-old patient who died aft er prolonged cardiac arrest. Kidney biopsy showed a 16% rate of sclerotic g lomeruli and mild interstitial fibrosis. The creatinine clearance estimated by the Cockcroft formula was 50 mL.min(-1). The double kidney transplantat ion was successful, without any surgical or anaesthetic complication. Resto ration of urine production was immediate. Three months after the transplant ation, creatinine clearance was 80 mL.min(-1). This observation gives the opportunity to discuss the criteria for organ ha rvesting in patients with cerebral death. Donor age should not remain anymo re a systematic contra indication for kidney or liver donation. Renal funct ion, macroscopic examination and histological findings seem more important for making a decision in taking the graft. Double transplantation, here the second case in France, has been performed for several years in other count ries, and has permitted to expand the pool of donors, thus increasing the n umber of transplanted patients. (C) 2001 Editions scientifiques et medicale s Elsevier SAS.