Younger kidney donors lead to better chance of graft survival
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The association of donor-recipient size mismatch on long-term graft survival is influenced greatly by recipient and donor age, according to findings from a recently published study.
“Although organ donor organizations do not consider donor-recipient size mismatch in allocation algorithms for deceased donor kidneys, this is one of the elements considered in the nal decision to accept or decline an offer for a deceased donor kidney for transplantation,” Fanny Lepeytre, MD, of the immunopathology division at the Centre Hospitalier de l’Universite de Montreal, and colleagues wrote. “The aims of this study were to determine whether the relationship between donor-recipient size mismatch and graft survival is modied by donor and/or recipient age and to assess whether young donor age could attenuate the adverse association of size mismatch on graft survival in some recipient age categories.”
In a retrospective cohort study, investigators analyzed data for 136,321 kidney transplant recipients to assess the association between donor-recipient body surface area ratio and death-censored graft survival. Researchers used multivariable Cox proportional hazard models to assess these associations.
Of the kidney transplant recipients included in this study, 17% experienced death-censored graft loss during a median follow-up of 4.3 years (IR 1.9 - 7.8 years). Investigators also found the three-way donor-recipient body surface ratio by age interaction was statistically significant , with associations between severe size mismatch (donor-recipient body surface area ratio <0.80 vs. 1) and death-censored graft survival stronger with older age.
“Donor and recipient ages modulate the association between size mismatch and graft survival. However, the association between donor-recipient size mismatch and long-term graft survival was modest compared with the association between donor age and graft survival,” Lepeytre and colleagues concluded. “A size-mismatched young donor led to equal or better estimated long-term graft survival rates than size-matched kidneys from donors aged over 40 years.”
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