Impact of Recipient Aging on Kidney Allograft in Living Donor Transplantation

Background. The aging of recipients is becoming increasingly important in organ transplantation. Patients and Methods. We analyzed outcomes in 215 consecutive adult kidney transplant recipients from living donors who underwent transplantation at our center between November 1988 and March 2012. The list of recipients was divided by age at transplantation into those aged 16 to 29 years (n = 61), 30 to 39 years (n = 69), 40 to 49 years (n = 33), 50 to 59 years (n = 29), and those 60 years or older (elderly group, n = 23). Cox proportional hazards analysis was used to calculate the relative risk (RR) of patient death and graft failure, with recipient age included as a continuous variable. Results. Univariate analysis showed that recipient age did not significantly affect the risk of graft failure, either uncensored (RR = 1.01, P = .312) or censored for death (RR = 0.993, P = .587). Multivariate analysis, however, showed that recipient age was an independent risk factor for patient death (RR = 1.053, P = .024). The patient survival rate was the poorest in elderly group (87.0%, P = .036), whereas the both death uncensored and censored graft survival rates of this group were 78.1% and 91.3%, respectively, comparable to those of other age groups (P = .567 and P = .696). Mean estimated glomerular filtration rate (eGFR) 1 year after transplantation was lower in elderly groups than in other groups (46.1 +/- 13.0 mL/min/1.73 m(2), P = .014). However, mean delta eGFR, defined as the difference between pretransplantation eGFR of the donor and eGFR of the recipient 1 year post-transplantation, did not differ significantly among age groups. Conclusion. Recipient age did not affect allograft deterioration in living donor kidney transplantation, although it was an independent risk factor of recipient death.