Results of Transplantation of Kidneys Procured From Donors After Brain Death Aged 60 Years and Older

Objective. To analyze results of transplantation of kidneys procured from donors after brain death aged 60 years and older (hereafter denoted by ">= 60") compared to kidneys procured from donors after brain death aged 40-59 years (hereafter denoted by "40-59") in medium-term follow-up period, and to assess factors that affect recipient and kidney graft survival. Material and methods. 92 transplant recipients of kidneys procured from donors after brain death >= 60 were enrolled into the study. The control group were 363 recipients of kidneys procured from donors after brain death 40-59. Results. Mean values of serum creatinine were higher in recipients of kidneys procured from donors after brain death >= 60 compared to control after 3 years: 168.2 +/- 57.5 (n = 59) vs 147.9 +/- 65.7 (n = 294), P < .05; and after 5 years: 196.2 +/- 95.3 (n = 38) vs 157.3 +/- 80.0 mu mol/L (n = 211), P < .01. Restricted mean recipient survival time was 56.4 (95% confidence interval: 55.0-57.8) and 52.0 (48.0-56.1) months, P < .05; and kidney graft survival time was 51.6 (49.6-53.5) and 43.9 (39.0-48.9) months, P < .01 in recipients who received kidneys from donors after brain death 40-59 and from donors after brain death >= 60 respectively. In Cox regression, donor death due to cardiovascular disease proved to be the factor increasing risk of kidney graft loss (hazard ratio 1.553, P < .001). Conclusions. The survival and function of kidneys procured from donors after brain death >= 60 at medium-term follow-up remain worse compared to kidneys procured from donors after brain death 40-59, and the donor dependent risk factor of kidney graft loss is cardiovascular disease, which caused donor death.