RECENTLY published data have shown that donor nephrectomy in living kidney donors aged 70 years or older is safe, and does not significantly impact estimated glomerular filtration rate (eGFR), or the risk of end-stage renal disease.
The current investigation was of a single-centre retrospective cohort design, examining 1,226 living kidney donors in a Japanese hospital between 2008–2020. The cohort was split into three arms: 244 patients aged 30–49 years, 803 patients aged 50–69, and 179 patients aged 70–89. The researchers compared surgical outcomes, postoperative eGFR changes, end-stage renal disease, and mortality rates across the cohorts. Postoperative assessments were conducted upon living kidney donors at 1, 3, 6, and 12 months after transplantation, and then annually. Patients with comorbidities were followed every 1 to 3 months, and across the study.
The results demonstrated no significant difference in surgical outcomes across all age groups, but patients aged 70–89 years had the lowest eGFR changes at all time points, as well as the lowest eGFR improvement. No cases of end-stage renal disease were observed in any of the groups, but the researchers did note that mortality rates were highest among patients aged 70–89 years compared to the other groups.
Lead researcher, Takahisa Hiramitsu, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Japan, highlighted the importance of this work: “Owing to a profound organ shortage, living donor kidney transplant involving elderly living kidney donors is becoming more frequent.” Hiramitsu also commented: “Regarding life expectancy, living donor kidney transplants involving living kidney donors aged 70 years or older are associated with favourable outcomes. The results of this study may aid in the discovery of optimal indications for pre-operative eGFRs of living kidney donors, and increase the number of eligible living kidney donors.”
