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Korean J Transplant 2021; 35(4): 238-246

Published online December 31, 2021

https://doi.org/10.4285/kjt.21.0020

© The Korean Society for Transplantation

Recipient efficacy and safety of kidney transplantation from older living donor: consideration for using older kidney as a solution to the shortage of organs

Ji Yeon Song1 , Kyo Won Lee1 , Kyunga Kim2,3 , Kyeong Deok Kim1 , Jaehun Yang1 , Ji Eun Kwon1 , Okjoo Lee1 , Jae Berm Park1

1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2 Biomedical Statistics Center, Data Science Research Institute, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
3 Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea

Correspondence to: Jae Berm Park
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
Tel: +82-2-3410-3647
Fax: +82-2-3410-0040
E-mail: jbparkmd@gmail.com

Received: August 27, 2021; Revised: September 16, 2021; Accepted: October 20, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: As a solution to organ shortages, studies on kidney transplantation (KT) from older donors are being conducted. However, many controversies remain about its safety and efficacy.
Methods: In Samsung Medical Center, from January 2000 to May 2015, 1,141 patients underwent living KT. Cases of retransplantation, recipient and donor aged younger than 18 years, and multiorgan transplantation were excluded, and a total of 859 cases were selected. Analysis was performed by dividing the patents into two groups: a younger donor group (donors <60 years old; n=826) and an older donor group (donors ≥60 years old; n=33).
Results: There were no significant differences between the two groups in patient death (log-rank P=0.173) or in postoperative complications. The older donor group had a higher acute rejection (P=0.034; hazard ratio [HR], 1.704) and graft failure rate (P=0.029, HR=2.352). There was no significant difference in the trend of estimated glomerular filtration rate over time (P=0.189).
Conclusions: KT using kidneys from old-aged donors is safe, but there is room for improvement due to problems with higher acute rejection and graft failure rate.

Keywords: Kidney transplantation, Living donors, Aged

HIGHLIGHTS
  • Organ shortage has been a big issue in kidney transplantation.

  • Postop complication and estimated glomerular filtration rate over time had no significant difference between the two groups.

  • Older donor kidney transplantation could be a solution to organ shortage.