Outcomes of Nonstandard Donor Kidney Transplants in Recipients Aged 70 Years or More: A Single-Center Experience.

Abstract

There is a global increase in the prevalence of end-stage kidney disease among the elderly. As a result, more elderly recipients are being considered for kidney transplants. Because of the scarcity of donor organs, such patients are more likely to receive transplants from nonstandard donor kidneys.Here, we examined the outcomes of kidney transplants with a nonstandard donor allograftin recipients ≥70 years of age. Records of patients who received transplants at a single UK centerfrom April 1, 2015, through March 31, 2021, were retrospectively analyzed to identify those who were ≥70 years old at the time of surgery. Outcomes ofthose who received a kidney transplantfrom a nonstandard donor (group 1) were compared to those who received a kidney transplant from a standard criteria donor or living donor (group 2). During the study period, of 670 kidney transplant procedures, 67 recipients (10%) were ≥70 years of age at the time of surgery, with 54 (80.6%) identified in group 1 and 13 (19.4%) identified in group 2. Cold ischemia time (P = .001) and incidence of delayed graft function (P = .044) were significantly higherin group 1. Duration of graft survival atthe end of follow-up was not different between the groups (log rank = 0.218), butthe mean serum creatinine values at 2 years (P = .016) and 3 years (P = .048) years were significantly higherin group 1. Patients in group 1 had shorter survival time (log rank = 0.037). Nonstandard donor kidneys should be used cautiously in elderly recipients as patient survival was shown to be comparatively poor compared with elderly recipients who received a kidney transplant from a standard criteria donor or a living donor.