For patients in need of a transplant who are at least 60 years old, rapid transplantation from an older deceased donor is superior to delayed transplantation from a younger donor, according to new study conducted by researchers at the University of British Columbia in Canada and Charité University Medicine, in Berlin. The study’s findings, appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), could lead to changes in current transplant allocation policies.
To investigate how to optimally increase the use of such “expanded criteria donor kidneys,” a team led by John Gill MD, MS, Caren Rose, PhD, (University of British Columbia, in Canada), and Elke Schaeffner, MD (Charité University Medicine, in Berlin) conducted a series of analyses of data from the Eurotransplant Senior Program and the United States Renal Data System.
They found that in patients in need of a transplant who are at least 60 years old, rapid transplantation from an older deceased donor is superior to delayed transplantation from a younger donor. The researchers also discovered that kidneys from older donors do not have sufficient longevity to provide younger patients with a lifetime of kidney function, but they do have sufficient longevity to provide older patients who have a shorter life expectancy with a lifetime of kidney function.
“Older patients derive a survival benefit from rapid transplantation with an older donor kidney, while younger patients do not derive a benefit from transplantation from an older kidney,” said Gill. “Ensuring older patients can access older donor kidneys should be a priority in the United States. This may involve increased utilization of older donor kidneys or possibly excluding younger patients from receiving these kidneys.”
Study co-authors include Ulrich Frei, MD and Jagbir Gill MD, MS.