Results of kidney transplantation from suboptimal donors to recipients of the older age group

Introduction. Among the growing number of patients with chronic renal failure who need dialysis therapy or kidney transplantation, a significant proportion are people over 60 years old, making from 30 to 45% of all patients who need dialysis, according to various sources. The elderly age of the recipient contributes to the risk of developing graft dysfunction due to the presence of concomitant diseases that worsen the immediate and long-term results of transplantation. And the probability of receiving a kidney graft in elderly patients is significantly lower than in young recipients. One of the ways to solve this problem is to use kidneys from suboptimal donors.

Material and methods. The analysis of clinical examinations, laboratory and instrumental test results obtained in 124 patients who underwent cadaveric kidney allotransplantation at the N.V. Sklifosovsky Research Institute for Emergency Medicine, including that from suboptimal donors, was carried out. Of these, 69 (55.6%) recipients aged 60 years and older were included in the main group (group 1), and 55 recipients younger than 60 years (44.4%) in the comparison group (group 2).

Results. Kidney transplantation to elderly patients (aged 60 years and older), including from a suboptimal donor, provides a sufficiently high efficiency with a 1-year recipient survival rate of 98.6% and a functioning graft for 1 year in 75.4% of cases, which does not differ from the survival rate of younger recipients (98.2%), but is inferior by the case rate of keeping the graft functioning (91.9%). Meanwhile, the parameters characterizing the functional state of the transplanted organs that maintained their function for 1 year did not differ statistically significantly between elderly and younger recipients.

Conclusions. The results of the study showed that kidney transplantation from suboptimal donors to patients of the older age group provides acceptable results with low mortality of recipients and a 1-year functioning of the graft in 75% of cases. This makes it possible to increase the availability of kidney transplantation for patients of the older age group and achieve better survival results, provided adequate selection of recipients and an objective assessment of the quality of transplanted organs.

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