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Kidney Week

Abstract: SA-PO098

Aged Kidney Grafts: Another Potential Long-Term Risk in Living Kidney Transplantation

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Yonemoto, Sayoko, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya-city, Hyōgo, Japan
  • Hamano, Takayuki, Osaka University Graduate School of Medicine, Suita, OSAKA-FU, Japan
  • Fujii, Naohiko, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya-city, Hyōgo, Japan
  • Isaka, Yoshitaka, Osaka University Graduate School of Medicine, Suita, OSAKA-FU, Japan
Background

As marital kidney transplantaion increases, the living kidney donor's age, or the age of the kidney graft at transplantaion, becomes older in Japan; however, its effect on graft survival has not been well-studied. We evaluated the long-term kidney function of both donors and recipients in transplantaion with aged or non-aged kidney grafts.

Methods

In this prospective observational study, we enrolled 130 consecutive living kidney donors and recipients (65 pairs) in a single transplant unit in Japan from November 1, 2008 to May 31, 2013. We divided them into two groups by donor’s age (D-Age<65 and D-Age≥65), and longitudinally followed estimated glomerular filtration rate (eGFR) every year until May 31, 2018. The temporal changes in eGFR of donors and recipients were analyzed by mixed effects models with random intercepts and random slopes, allowing a quadratic term for time-interaction and a 2-by-2 factorial interaction (D-Age and donor-recipient).

Results

The median donors' and recipients' ages were 60 and 46 years old, respectively. We had 19 donors (29.2%) who were over 65 years old. We had 39 females (60%) in donors and 25 females (38.5%) in recipients. There was no significant difference in eGFR before donation between D-Age<65 and D-Age≥65 group. In the D-Age≥65 group, eGFR declines started in donors and recipients four years and two years after transplantation, respectively, while in the D-Age<65 group eGFR was sustained in donors and slightly decline in recipients (p for interaction<0.01). No significant difference in trajectory of eGFR was observed between recipients and their donors in D-Age≥65 group (p=0.50).

Conclusion

In this study, eGFRs in both donors and recipients were declined after living kidney transplantation with aged grafts. We should be careful when we use aging kidney in transplantaion.