Age alone is not a contraindication to kidney donation

Outcomes of donor nephrectomy in the elderly

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3 Citations (Scopus)

Abstract

With increasing organ demand, living kidney donation from older donors (>60-years-old) has become more common. Between 1975 and 2014, 3752 donor nephrectomies (DN) were performed at University of Minnesota; 167 (4.5%) were >60-years-old Short- and long-term outcomes were compared between contemporaneous >60-years-old and <60-years-old donors. On univariate analysis, >60-years-old were more likely to have had prior abdominal surgery and hypertension; and less likely to smoke. Baseline estimated glomerular filtration rate (eGFR) was lower in >60-years-old (80 ± 16 vs 101 ± 26 mL/min/1.73 m2; P <.001). Intraoperative and postoperative complications were similar, except a higher prevalence of <30 day ileus (3% vs 7%; P =.021) and longer postoperative length of stay (LOS) (4.2 vs 4.6 days; P =.005). On multivariate analysis, <30 day ileus and LOS continued to be significantly greater for >60-years-old After >20 years post-DN, systolic blood pressure was significantly higher among >60-years-old (142 vs 125 mm Hg; P <.001) and HTN was diagnosed earlier (9 vs 14 years). After donation, eGFR was significantly lower for >60-years-old but slope of eGFR and rates of end-stage renal disease (ESRD) were not significantly different >20 years post-DN. Thus, kidney donation among carefully selected >60-years-old poses minimal perioperative risks and no added risk of long-term ESRD.

Original languageEnglish (US)
Article numbere13287
JournalClinical Transplantation
Volume32
Issue number8
DOIs
StatePublished - Aug 1 2018

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Nephrectomy
Tissue Donors
Kidney
Glomerular Filtration Rate
Chronic Kidney Failure
Blood Pressure
Smoke
Hypertension

Keywords

  • donor nephrectomy
  • elderly
  • living donor kidney transplant

Cite this

@article{dfacd9b456094435b0e9b560de79b9c6,
title = "Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly",
abstract = "With increasing organ demand, living kidney donation from older donors (>60-years-old) has become more common. Between 1975 and 2014, 3752 donor nephrectomies (DN) were performed at University of Minnesota; 167 (4.5{\%}) were >60-years-old Short- and long-term outcomes were compared between contemporaneous >60-years-old and <60-years-old donors. On univariate analysis, >60-years-old were more likely to have had prior abdominal surgery and hypertension; and less likely to smoke. Baseline estimated glomerular filtration rate (eGFR) was lower in >60-years-old (80 ± 16 vs 101 ± 26 mL/min/1.73 m2; P <.001). Intraoperative and postoperative complications were similar, except a higher prevalence of <30 day ileus (3{\%} vs 7{\%}; P =.021) and longer postoperative length of stay (LOS) (4.2 vs 4.6 days; P =.005). On multivariate analysis, <30 day ileus and LOS continued to be significantly greater for >60-years-old After >20 years post-DN, systolic blood pressure was significantly higher among >60-years-old (142 vs 125 mm Hg; P <.001) and HTN was diagnosed earlier (9 vs 14 years). After donation, eGFR was significantly lower for >60-years-old but slope of eGFR and rates of end-stage renal disease (ESRD) were not significantly different >20 years post-DN. Thus, kidney donation among carefully selected >60-years-old poses minimal perioperative risks and no added risk of long-term ESRD.",
keywords = "donor nephrectomy, elderly, living donor kidney transplant",
author = "Oscar Serrano and Kunal Yadav and Bangdiwala, {Ananta S} and Vock, {David M} and Dunn, {Ty B} and Finger, {Erik B} and Pruett, {Timothy L} and Matas, {Arthur J} and Raja Kandaswamy",
year = "2018",
month = "8",
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doi = "10.1111/ctr.13287",
language = "English (US)",
volume = "32",
journal = "Clinical Transplantation",
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TY - JOUR

T1 - Age alone is not a contraindication to kidney donation

T2 - Outcomes of donor nephrectomy in the elderly

AU - Serrano, Oscar

AU - Yadav, Kunal

AU - Bangdiwala, Ananta S

AU - Vock, David M

AU - Dunn, Ty B

AU - Finger, Erik B

AU - Pruett, Timothy L

AU - Matas, Arthur J

AU - Kandaswamy, Raja

PY - 2018/8/1

Y1 - 2018/8/1

N2 - With increasing organ demand, living kidney donation from older donors (>60-years-old) has become more common. Between 1975 and 2014, 3752 donor nephrectomies (DN) were performed at University of Minnesota; 167 (4.5%) were >60-years-old Short- and long-term outcomes were compared between contemporaneous >60-years-old and <60-years-old donors. On univariate analysis, >60-years-old were more likely to have had prior abdominal surgery and hypertension; and less likely to smoke. Baseline estimated glomerular filtration rate (eGFR) was lower in >60-years-old (80 ± 16 vs 101 ± 26 mL/min/1.73 m2; P <.001). Intraoperative and postoperative complications were similar, except a higher prevalence of <30 day ileus (3% vs 7%; P =.021) and longer postoperative length of stay (LOS) (4.2 vs 4.6 days; P =.005). On multivariate analysis, <30 day ileus and LOS continued to be significantly greater for >60-years-old After >20 years post-DN, systolic blood pressure was significantly higher among >60-years-old (142 vs 125 mm Hg; P <.001) and HTN was diagnosed earlier (9 vs 14 years). After donation, eGFR was significantly lower for >60-years-old but slope of eGFR and rates of end-stage renal disease (ESRD) were not significantly different >20 years post-DN. Thus, kidney donation among carefully selected >60-years-old poses minimal perioperative risks and no added risk of long-term ESRD.

AB - With increasing organ demand, living kidney donation from older donors (>60-years-old) has become more common. Between 1975 and 2014, 3752 donor nephrectomies (DN) were performed at University of Minnesota; 167 (4.5%) were >60-years-old Short- and long-term outcomes were compared between contemporaneous >60-years-old and <60-years-old donors. On univariate analysis, >60-years-old were more likely to have had prior abdominal surgery and hypertension; and less likely to smoke. Baseline estimated glomerular filtration rate (eGFR) was lower in >60-years-old (80 ± 16 vs 101 ± 26 mL/min/1.73 m2; P <.001). Intraoperative and postoperative complications were similar, except a higher prevalence of <30 day ileus (3% vs 7%; P =.021) and longer postoperative length of stay (LOS) (4.2 vs 4.6 days; P =.005). On multivariate analysis, <30 day ileus and LOS continued to be significantly greater for >60-years-old After >20 years post-DN, systolic blood pressure was significantly higher among >60-years-old (142 vs 125 mm Hg; P <.001) and HTN was diagnosed earlier (9 vs 14 years). After donation, eGFR was significantly lower for >60-years-old but slope of eGFR and rates of end-stage renal disease (ESRD) were not significantly different >20 years post-DN. Thus, kidney donation among carefully selected >60-years-old poses minimal perioperative risks and no added risk of long-term ESRD.

KW - donor nephrectomy

KW - elderly

KW - living donor kidney transplant

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U2 - 10.1111/ctr.13287

DO - 10.1111/ctr.13287

M3 - Article

VL - 32

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 8

M1 - e13287

ER -