Living Donor Age and Kidney Transplant Outcomes |
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Authors: | K. Noppakun F. G. Cosio P. G. Dean S. J. Taler R. Wauters J. P. Grande |
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Affiliation: | 1. Division of Nephrology and Hypertension, Department of Internal Medicine and William von Liebig transplant Center;2. Visiting clinician;3. Department of Surgery and William von Liebig transplant Center;4. Department of Pathology;5. Mayo Clinic, Rochester, MN |
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Abstract: | We assessed the relationship between living donor (LD) age and kidney survival in 1063 adults transplanted between 1980 and 2007. Increasing LD age was associated with lower kidney function (GFR) before and after transplantation and loss of GFR beyond 1 year. Increasing LD age was also associated with low‐moderate proteinuria posttransplant (151–1500 mg/day, p < 0.0001). By univariate analysis, reduced graft survival related to lower GFR at 1 year [HR = 0.925 (0.906–0.944), p < 0.0001], proteinuria [HR = 1.481 (1.333–1.646), p < 0.0001] and increasing LD age [HR = 1.271 (1.219–1.326), p = 0.001]. The impact of LD age on graft survival was noted particularly >4 years posttransplant and was modified by recipient age. Thus, compared to a kidney graft that was within 5 years of the recipient age, younger kidneys had a survival advantage [HR = 0.600 (0.380–0.949), p = 0.029] while older kidneys had a survival disadvantage [HR = 2.217 (1.507–3.261), p < 0.0001]. However, this effect was seen only in recipients <50 years old. By multivariate analysis, the relationship between LD age and graft survival was independent of GFR but related to proteinuria. In conclusion, LD age is an important determinant of long‐term graft survival, particularly in younger recipients. Older kidneys with reduced survival are identifiable by the development of proteinuria posttransplant. |
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Keywords: | Donor age graft survival living donor kidney transplantation proteinuria |
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