A single transplant center analysis of 181 living kidney donors categorized by age revealed that “donor age…was not a risk factor for patient or graft survival”.
The death-uncensored graft survival rates in the 3 subgroups (.39; 40-59; 60+) were 64.5%, 76.0% and 90.9%, respectively, whereas their mean estimated glomerular filtration rates 1 year after transplantation were 40.7 ± 7.4, 41.0 ± 10.7 and 51.4 ± 14.3 ml/min/1.73 m2, respectively (p=0.025).
In other words, using kidneys from living donors 60+ years of age for recipients 60+ years of age produces the best results (as opposed to 60+ LKDs for younger recipients).
According to the USRDS, the average age of end-stage renal disease onset is 64.4 years old, so why shouldn’t their “replacement” kidney be approximately the same age? Older donors will be screened for (and free of) the chronic conditions that won’t have yet appeared in younger LKDs (diabetes, heart disease, kidney disease), because those conditions don’t rear their heads until a more advanced age, Also, the long-term risks of living kidney donation (heart disease, kidney disease, bone disease) won’t have time to take root in LKDs over 60.
According to the US census, 19.2% of the US population in 2012 was 60 years of age and older; another 27.5% is 40-60 years of age. Over the next twenty years, it is this second group that will need kidneys far more than anyone else. Unless US population tides shift, there simply won’t be enough younger people to use as their medical supply.
Of course, the best and only solution is to implement robust prevention and treatment programs for kidney disease, but until then, maximizing utilization will have to do.
Tanaka, S. (2014). Old-for-Old Age Matching in Living Donor Kidney Transplantation: A Single-Center Experience Journal of Transplantation Technologies & Research, 04 (02) DOI: 10.4172/2161-0991.1000141