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      Influence of Donor Age on Cadaver Kidney Graft Function and Survival: Univariate and Multivariate Analyses

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          Abstract

          The influence of donor age on the outcome of kidney transplantation (TX) was evaluated in 169 patients who received a primary cadaver kidney transplant at our center between September 16,1984, and December 31,1990. All the patients received cyclosporin A as part of the immunosuppressive protocol. Patients were grouped according to donor age: low donor age (LDA; donor age range 12-25 years), medium donor age (MDA; range 26-50 years) and high donor age (HDA; range 51-66 years). There were no differences between groups in graft and patient survival, and multivariate analysis did not show any effect of donor age on those parameters. Proteinuria/day and number of rejection episodes did not differ between groups either. Immediate diuresis was more frequent in group LDA than in the other two groups (73.8, 54.7 and 57.1%, respectively; p < 0.05) and immediate diuresis resulted as a weak positive prognostic factor for graft outcome at multivariate analysis (p = 0.05). At both univariate and multivariate analyses, donor age resulted inversely correlated with creatinine clearance (C<sub>Cr</sub>) at every period after TX but the 5th year, with r<sup>2</sup> from 0.12 to 0.23 (p < 0.01). The LDA group had significantly better C<sub>Cr</sub>than the HDA group at every period after TX but for the 5th year (the MDA group behaved intermediately). Moreover, in the 65 patients with a follow-up of 4 years or more, not only did the LDA group have the best C<sub>Cr</sub> (LDA vs. MDA and HDA: p < 0.02) but also C<sub>Cr</sub> remained roughly stable with time in groups LDA and MDA while it declined progressively with time in group HDA. The influence of donor age on hypertension after TX was negligible when compared to that of dialytic age and recipient sex. Our data show that kidneys from donors 12-25 years old give the best functional results, while those from donors over 50 are associated with the lowest kidney function. Moreover, if the reduced frequency of immediate diuresis and the progressive decline of C<sub>Cr</sub> with time are taken into account, kidneys from donors over 50 are also probably associated with reduced graft survival in the long term (after the 10th year). We suggest that kidneys from donors over 50 may be used, but they should be probably given to patients with a life expectation of no more than 10-15 years.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1993
          1993
          12 December 2008
          : 65
          : 4
          : 541-548
          Affiliations
          aTransplant Center, bThird Surgery Division and c1st Surgery Division, Treviso General Hospital, Treviso, Italy
          Article
          187561 Nephron 1993;65:541–548
          10.1159/000187561
          8302407
          © 1993 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 8
          Categories
          Original Paper

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