Significant Decrease in Glomerular Filtration Rate at 5 Years Posttransplantation in the Recipients of Live Donor Kidneys 50 Years of Age or Older

Introduction

Age is an established predictor of renal failure among recipients of cadaveric transplants; however, the impact of donor age on recipient glomerular filtration rate (GFR) among living donor kidney (LDK) transplantations is not well established.

Methods

We retrospectively analyzed recipient posttransplantation GFR at 12, 36, and 60 months among 315 LDK allograft recipients. The impact of donor age was assessed on the recipient estimated GFR (eGFR) using multivariate linear regression stratified according to donor age <50 years (n = 246) and ≥50 years (n = 69).

Results

Whites comprised the majority of both donors and recipients (77%). The majority (58.4%) of donors were female. Mean age (± SD) of the donors was 41.0 ± 10.2 years (range, 20-65 years). The mean age and body mass index (BMI) of the recipients were 43.3 ± 12.4 years and 26.0 ± 4.9, respectively. There was no statistically significant difference in the rejection rate between the 2 groups (P = .571). Mean eGFR at 12 months in the younger group was 63.3 ± 23.7 compared with 54.8 ± 19.7 in the older group (P = .015). Similarly, a significant difference was observed at the end of 36 months and 60 months of follow-up (61.5 ± 23.1 vs 49.4 ± 18.9, and 59.4 ± 23.0 vs 45.3 ± 20.8, respectively; both P = .001). Donor age was a statistically significant predictor of eGFR throughout the study period (P < .05).

Conclusion

Donor age predicts recipient renal function after living kidney transplantation and needs to be evaluated through a larger prospective investigation.