Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly |
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| Authors: | Oscar K. Serrano Kunal Yadav Ananta Bangdiwala David M. Vock Ty B. Dunn Erik B. Finger Timothy L. Pruett Arthur J. Matas Raja Kandaswamy |
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| Affiliation: | 1. Division of Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA;2. Hume‐Lee Transplant Center, Virginia Commonwealth University, Richmond, VA, USA;3. Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA;4. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA |
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| Abstract: | 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 m2; 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. |
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| Keywords: | donor nephrectomy elderly living donor kidney transplant |
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