Never too old to donate a kidney?

Individuals over 70 years old can safely donate without risking their lives

Press release
EurekAlert
Washington, DC -- People over age 70 years of age can safely donate a kidney, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). The results provide good news for patients who need a kidney but have limited options for donors; however, kidneys from these elderly donors do not last as long as those from younger living donors.

Because of a profound shortage in organs for transplantation, patients in need of a kidney face long waiting times and increased risks of dying. In response, patients are turning to older living donors. This brings up an important question: should there be an upper age limit for donation for the sake of both recipients' and donors' health?

To investigate, Jonathan Berger, MD, Dorry Segev, MD, PhD (Johns Hopkins University School of Medicine), and their colleagues studied 219 healthy adults over the age of 70 years who donated kidneys and compared them with healthy elderly individuals who were not organ donors. The researchers looked to see if these older donors put themselves at extra risk of death by donating and having one kidney versus having two. The team also wanted to know if a kidney from a living donor over 70 years of age was as good as other donor organs. To do so, they compared the kidney health of recipients of older donor kidneys to that of recipients of kidneys from younger donors and deceased donors.

Healthy individuals over 70 years old were no more likely to die within one, five, or 10 years after donating than healthy elderly individuals who were not organ donors; in fact, their death rates were lower. The organs from elderly donors did not last as long as those from younger living donors, but they lasted just as long as organs from younger deceased donors.

"It is important for individuals over 70 who want to donate a kidney to be aware that many have done so safely. Many older adults -- and even many physicians -- are not even aware that this occurs," said Dr. Segev. "But it is important for transplant centers to continue to scrutinize all donor candidates, particularly older ones," he added.

Contact: Shari Leventhal
sleventhal@asn-online.org
202-640-1394
American Society of Nephrology

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Liver transplants from elderly donors are safe

Reuters

NEW YORK (Reuters Health) - Advanced donor age, per se, does not adversely affect the transplant recipient or the survival of the organ after liver transplantation, according to a report in the Journal of the American College of Surgeons.

Previous reports have indicated that the age of the donor -- older than 60 years - contributes to decreased organ and patient survival, as well as a poorer quality of life for the recipient, the authors explain. They hypothesized, however, "that proper selection of donors older than age 60 and even over age 70" can produce outcomes comparable to those obtained with younger donors.

Dr. William C. Chapman and colleagues from Washington University School of Medicine, St. Louis, Missouri, analyzed their experience with 741 adult-to-adult whole organ transplants -- 91 donors were 60 years or older and 650 were younger than 60 years.

There was no significant difference in the number of second transplants performed or signs that another transplant was going to be needed between patients who received organs from younger and older donors, the authors report.

Overall survival rates did not significantly differ between the two groups of patients, the researchers note. Five-year survival, for example, was 67.6 percent in the patients who received organs from older donors compared with 75.5 percent in those who received organs from younger donors.

Similarly, organ survival was not significantly different between recipients of organs from younger and older donors, even when the donors were separated into three age groups - younger than 60 years, 60 to 69 years and 70 years or older.

Time between organ removable and transplant was significantly shorter for organs from older donors than for organs from younger donors, the report indicates.

"Our analysis was not able to identify any significant disadvantage in graft or patient survival based on donor age," the authors noted.

Other donor risk factors, such as time from organ removal to transplant and variables associated with the recipient are all "important to ensure optimal outcomes" of transplants from older donors, they add.

Overall, the investigators conclude that "older donors represent an important and safe expansion of the donor pool."

SOURCE: Journal of the American College of Surgeons, December 2008.

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