Study: Donor nephrectomy in living kidney donors aged 70 years or older is safe
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Key takeaways:
- Findings showed no significant differences in surgical outcomes among age groups.
- Mortality rates were highest among patients aged 70 to 89 years.
Donor nephrectomy in living kidney donors aged 70 years or older is safe and does not significantly impact eGFR or the risk of end-stage renal disease, recently published data show.
“Owing to a profound organ shortage, [living-donor kidney transplant] LDKT involving elderly [living kidney donors] LKDs is becoming more frequent,” Takahisa Hiramitsu, of the department of transplant and endocrine at the Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, wrote with colleagues. “However, no studies have reported the detailed eGFR changes after donor nephrectomy among donor age groups.”
A single-center retrospective cohort study examined 1,226 LKDs in a Japanese hospital who had a donor nephrectomy between 2008 and 2020. In total, there were 244 patients aged 30 to 49 years in one group, 803 patients aged 50 to 69 years in another group and 179 patients aged 70 to 89 years in the final group. Researchers compared surgical outcomes, postoperative eGFR changes, ESRD and mortality rates among the three cohorts.
Investigators ran postoperative assessments on LKDs at 1, 3, 6 and 12 months after transplantation, then annually. Patients with comorbidities were followed every 1 to 3 months and across the study, patients were followed until 2022.
Findings showed no significant differences in surgical outcomes among age groups. Patients aged 70 to 89 years had the lowest eGFR changes at all time points and lowest eGFR improvement. No cases of ESRD were seen in any group during observation, according to the researchers.
Hiramitsu and colleagues noted, however, that mortality rates were highest among patients aged 70 to 89 years compared with the other age groups.
“Despite the low eGFR changes and improvement after donor nephrectomy, LKDs aged 70 years or older can maintain their kidney function without ESRD,” the authors wrote. “Regarding life expectancy, LDKTs involving LKDs aged 70 years or older are associated with favorable outcomes. The results of this study may aid in the discovery of optimal indications for preoperative eGFRs of LKDs and increase the number of eligible LKDs.”
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