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Living Donation Discussion and News => Living Donation in the News => Topic started by: Clark on April 01, 2011, 09:35:04 PM
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http://onlinelibrary.wiley.com/doi/10.1111/j.1600-6143.2011.03465.x/abstract;jsessionid=138FDCDD99B9BBF35EBD7C818E925F50.d03t02
Living Kidney Donors: Impact of Age on Long-Term Safety
L. F. C. Dols, N. F. M. Kok, J. I. Roodnat, T. C. K. Tran, T. Terkivatan, W. C. Zuidema, W. Weimar, J. N. M. IJzermans
American Journal of Transplantation
Volume 11, Issue 4, pages 737–742, April 2011
Article first published online: 29 MAR 2011
DOI: 10.1111/j.1600-6143.2011.03465.x
Abstract
The safety of older live kidney donors, especially the decline in glomerular filtration rate (GFR) after donation, has been debated. In this study we evaluated long-term renal outcome in older live kidney donors. From 1994 to 2006 follow-up data of 539 consecutive live kidney donations were prospectively collected, during yearly visits to the outpatient clinic. Donors were categorized into two groups, based on age: <60 (n = 422) and ≥60 (n = 117). Elderly had lower GFR predonation (80 vs. 96 mL/min respectively, p < 0.001). During median follow-up of 5.5 years, maximum decline in eGFR was 38%± 9% and the percentage maximum decline was not different in both groups. On long-term follow-up, significantly more elderly had an eGFR <60 mL/min (131 (80%) vs. 94 (31%), p < 0.001). However, renal function was stable and no eGFR of less than 30 mL/min was seen. In multivariate analysis higher body mass index (HR 1.09, 95%CI 1.03–1.14) and more HLA mismatches (HR 1.17, 95%CI 1.03–1.34) were significantly correlated with worse graft survival. Donor age did not influence graft survival. After kidney donation decline in eGFR is similar in younger and older donors. As kidney function does not progressively decline, live kidney donation by elderly is considered safe.
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The subjects were only studied for five years. We know from studies of living kidney donors diagnosed with end-stage renal disease that the it occurs approximately twenty years post-donation, and after a long period of GFR stability.
For more: http://www.livingdonor101.com/LKD-kidney-disease.shtml (http://www.livingdonor101.com/LKD-kidney-disease.shtml)