Nephrol Dial Transplant (2000) 15: 696-700
© 2000 European Renal Association-European Dialysis and Transplant Association
Age-matching in renal transplantation
1 Department of Nephrology, University Hospital Charité, Campus Charité Mitte, Humboldt-University, Berlin, 2 Department of Nephrology, Friedrich-Alexander-University Erlangen-Nuremberg, Nuremberg and 3 Department of Nephrology, Johann Wolfgang Goethe University, Frankfurt, Germany
Background. So far, the combined influence of donor age and recipient age on renal allograft survival has not been investigated sufficiently. In this retrospective single-centre study we analysed whether the influence of donor age and recipient age on renal allograft survival are dependent on each other.
Methods. Data from 1269 cadaveric renal allograft transplantations were evaluated. Paediatric donors (<15 years) and paediatric recipients (<15 years) were excluded. Donors and recipients were divided by age: young donors (yd, 
55 years, n=1093), old donors (od, >55 years, n=176), young recipients (yr, 55 years, n=1058), and old recipients (or, >55 years, n=211). Functional and actual long-term graft survival (8 years) within the four resulting groups was determined: yd/yr (n=926), yd/or (n=167), od/yr (n=132), and od/or (n=44).
Results. Univariate analysis showed that long-term graft survival of both, kidneys from young donors (functional, 66.1 vs 52.2%, P=0.004; actual, 53.3 vs 46.2%, P=0.065) and kidneys from old donors (functional, 68.7 vs 22.5%, P=0.07; actual, 57.1 vs 20.8%, P=0.15) was better in old recipients as compared to young recipients. Multivariate regression analysis revealed that actual graft survival of kidneys from old donors was significantly reduced in young recipients (od/yr) as compared to all other groups (P=0.001; RR, 1.97; 95% CI, 1.32–2.94). In this group of patients, graft loss was mainly due to acute (33.7%) and chronic (24.0%) rejection.
Conclusion. Transplantation of kidneys from ‘old’ donors into ‘young’ recipients should be avoided, and these kidneys should be given to age-matched recipients.
Keywords: age-matching; graft survival; renal transplantation
Correspondence and offprint requests to: Dr med. Johannes Waiser, Medizinische Klinik mit Schwerpunkt Nephrologie, Universitätsklinikum Charité, Campus Charité Mitte, Schumannstrasse 20/21, D-10117 Berlin, Germany.
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