Renal transplantation from older donors

The aim of this study was to evaluate the utilization of kidneys from cadaveric donors older than 60 years and to evaluate the results of renal transplant performed reformed with kidneys from these older donors. Two hundred and fifty four out of a total of 1224 offers of kidneys to renal transplant that our group recived from January-1990 to Dicember-1996 were from donors older than 60 years. During his period of time these offers of kidneys from older donors were increasing from 11 in 1990 (9,4% of all offers in this year) to 78 in 1996 (35%). The number of offers of kidneys from older donors rejected for transplant augmented from 1990 (18%) to 1996 (35%). The number of kidney transplanted from donor older than 60 years was three times more in 1996 than in 1990: 19 (18,4%) vs. 7 (8,4%). One hundred and thirty five kidneys from donors older than 60 years had a surgical exploration before the renal transplant and then 46 of these kidneys were rejected because sclerosis and other diferent anatomical problems and the remaining 89 kidneys were transplanted (81 in our hospital). The rate of kidney from donors older than 60 years rejected to be transplant was significantly higher than rate of kidneys from younger donors (34% vs. 10,4%, p < 0,001). Eighty out of the 645 renal transplant performed in Hospital 12 de Octubre from 1990 to 1996 were from donors older than 60 years (one out off the eighty recipients recived a simultaneus double renal transplant from a donor 89 years old). The mean age of the donors and the recipients was 66 +/- 4,7 (r: 60-89) and 58 +/- 7 (29-71) years respectively. The cold ischemia time was 22 +/- 5 hours and the rate of acute tubular necrosis reached a 65%. A forty one percent of recipients had acute rejection. The one and three years actuarial survival of the graft was 70% and 64% respectively and the one and three year actuarial survival of the patient was 98% and 90%. In conclusion, the number of kidneys from donors older than 60 years was increased in the last years. Although many of these kidneys from older donors are rejected for transplant, the number of renal transplant performed with kidneys from these donors augmemted in the last years with satisfactory results.