Skip to main content
SpringerLink
Log in

The influence of age on outcome after renal transplantation

  • Published:
Geriatric Nephrology and Urology

Abstract

The influence of donor age and recipient age on outcome after renal transplantation has been investigated in numerous studies. There is some evidence that patient survival in elderly patients who receive a transplant is significantly higher compared with those, who remain on dialysis. In general, patient survival after renal transplantation is mainly dependent on recipient age and on comorbid conditions. Concerning graft survival, most studies conclude that the survival of kidneys taken from older donors (>50 years) and very young donors (<5 years) is reduced. Graft survival was also found to be reduced in very young recipients (<5 years). Functional graft survival proved to be better in older recipients (>50 years) as compared to younger recipients, due to a reduced immunologic response capability. Actual graft survival however, where cases of death with functioning graft are included, is fairly equal in both populations. The question, whether the age difference between donor and recipient has an influence on graft survival, needs to be further investigated. In conclusion, donor and recipient age are important risk factors, which may influence outcome after renal transplantation and therefore should be considered carefully.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lucas BA, Vaughn WK, Spees EK, Sanfilippo F. Identification of donor factors predisposing to high discard rates of cadaver kidneys and increased graft loss within one year posttransplantation-SEOPF 1977-1982. Transplantation 1987; 43: 253-8.

    PubMed  CAS  Google Scholar 

  2. Guo TJ, Daily OP, Davies DB. The UNOS OPTN waiting list: 1988 to 1994. Clin Transplant 1994; 8: 69-86.

    Google Scholar 

  3. Cecka JM, Terasaki PI. The UNOS scientific renal transplant registry. Clin Transplant 1994; 8: 1-18.

    Google Scholar 

  4. Cohen B, Persijn G, De Meester J. Eurotransplant International Foundation: Annual report 1995.

  5. Epstein M. Aging and the kidney. J Am Soc Nephrol 1996; 7: 1106-22.

    PubMed  CAS  Google Scholar 

  6. Alexander JW, Bennett LE, Breen TJ. Effect of donor age on outcome of kidney transplantation. Transplantation 1994; 57: 871-6.

    PubMed  CAS  Google Scholar 

  7. Sautner T, Götzinger P, Wamser P, Gnant M, Steininger R, Mühlbacher F. Impact of donor age on graft function in 1180 consecutive kidney recipients. Transplant Proc 1991; 23: 2598-601.

    PubMed  CAS  Google Scholar 

  8. Feduska JN Jr, Cecka JM. Donor Factors. Clin Transplant 1994; 8: 381-94.

    Google Scholar 

  9. Chertow GM, Brenner BM, Mackenzie HS, Milford EL. Non-immunologic predictors of chronic renal allograft failure: Data from the United Network of Organ Sharing. Kidney Int 1995; 48 Suppl 52: 48-51.

    Google Scholar 

  10. Preuschof L, Lobo C, Offermann G. Role of cold ischemia time and vascular rejection in renal grafts from elderly donors. Transplant Proc 1991; 23: 1300-1.

    PubMed  CAS  Google Scholar 

  11. Rao KV, Kasiske BL, Odlund MD, Ney AL, Andersen RC. Influence of cadaver donor age on posttransplant renal function and graft outcome. Transplantation 1990; 49: 91-5.

    PubMed  CAS  Google Scholar 

  12. Thorogood J, van Houwelingen JC, van Rood JJ, Zantvoort FA, Schreuder GMT, Persijn GG. Factors contributing to longterm kidney graft survival in Eurotransplant. Transplantation 1992; 54: 152-8.

    PubMed  CAS  Google Scholar 

  13. Thorogood J, Houwelingen JC, Persijn GG, Zantvoort FA, Schreuder GMT, van Rood JJ. Prognostic indices to predict survival of first and second renal allografts. Transplantation 1991; 52: 831-6.

    PubMed  CAS  Google Scholar 

  14. Opelz G (für die kollaborative Transplantationsstudie). Prognostische Faktoren für den Verlauf nach Nierentransplantation. Urologe [A] 1994; 33: 377-82.

    CAS  Google Scholar 

  15. Feduska NJ Jr. Donor factors in cadaveric renal transplantation. Clin Transplant 1993; 7: 351-7.

    Google Scholar 

  16. Blümke M, Keller H, Fischer J, Eble F, Nausner M, Kirste G. Donor age is a risk factor in cadaver kidney transplantation. Transplant Proc 1992; 24: 2728.

    PubMed  Google Scholar 

  17. Transplantationsgruppe Mittelfranken. Twenty-five years of renal transplantation from a single center: a risk factor analysis for short-and long-term outcomes. Clin Investig 1993; 71: 341-50.

    Google Scholar 

  18. Busson M, Benoit G, N'Doye P, Hors J. Analysis of cadaver donor criteria on the kidney transplant survival rate in 5,129 transplantations. J Urol 1995; 154: 356-60.

    Google Scholar 

  19. Korb SM, Pustay M, Kolovich R, Blackburn S, Light JA. Renal transplantation of organs from donors over 50 years of age. Transplant Proc 1989; 21: 1940-1.

    PubMed  CAS  Google Scholar 

  20. Troppmann C, Almond PS, Escobar FS, Morel Ph, Papalois AE, Dunn DL, et al. Donor age and cause of death affect cadaver renal allograft outcome. Transplant Proc 1991; 23: 1365-6.

    PubMed  CAS  Google Scholar 

  21. Hüls S, Schreiber M, Riess R, Neumayer H-H. Kidneys from pediatric donors: a source of increased risk for graft failure in recipients. Transplant Proc 1993; 25: 2610-3.

    PubMed  Google Scholar 

  22. Schreiber M, Hüls S, Kühn R, Neumayer H-H. Causes of early graft failure at less than 12 months after renal transplantation. Transplant Proc 1993; 25: 2614-5.

    PubMed  CAS  Google Scholar 

  23. Neumayer H-H, Hüls S, Schreiber M, Riess R, Luft FC. Kidneys from pediatric donors: risk versus benefit. Clin Nephrol 1994; 41: 94-100.

    PubMed  CAS  Google Scholar 

  24. Johnson RWG, Webb NJA, Lewis MA, Postlethwaite RJ, Dyer PA, Connolly JK. Outcome of pediatric cadaveric renal transplantation: a 10 year study. Kidney Int 1996; 49 Suppl 53: 72-76.

    Google Scholar 

  25. Yuge J, Cecka JM. Pediatric recipients and donors. Clin Transplant 1990; 4: 425-36.

    Google Scholar 

  26. Ruder H, Schaefer F, Gretz N, Möhring S, Schärer K. Donor kidneys of infants and very young children are unacceptable for transplantation. Lancet 1989; 2: 168.

    Article  PubMed  CAS  Google Scholar 

  27. Opelz G. Influence of recipient and donor age in pediatric renal transplantation. Transplant Int 1988; 1: 95-8.

    Article  CAS  Google Scholar 

  28. Squifflet JP, Gianello P, Nesa S, Alexandre GPJ. Infants and very young children as kidney donors. Lancet 1989; 2: 745.

    Article  PubMed  CAS  Google Scholar 

  29. Modlin C, Novick AC, Goormastic M, Hodge E, Mastrioanni B, Myles J. Long-term results with single pediatric donor kidney transplants in adult recipients. J Urol 1996; 156: 890-5.

    Article  PubMed  CAS  Google Scholar 

  30. Feldman HI, Fazio I, Roth D, Berlin JA, Brayman K, Burns JE, et al. Recipient body size and cadaveric renal allograft survival. J Am Soc Nephrol 1996; 7: 151-7.

    PubMed  CAS  Google Scholar 

  31. Banafsche R, Pomer S, Motzkau D, Jansen S, Staehler G, Bretan PN Jr. Verbesserung des Organüberlebens bei der Transplantation von Kindernieren durch Optimierung des Spender-Empfänger-Größ enverhältnisses. Urologe [A] 1996; 35: 18-25.

    CAS  Google Scholar 

  32. Friedrich J, Albrecht K-H, Claus M, Eigler FW. Einfluß von Spender-und Empfängeralter auf die Ergebnisse der Nierentransplantation. Dtsch Med Wochenschr 1995; 120: 467-71.

    Article  PubMed  CAS  Google Scholar 

  33. Segoloni GP, Messina M, Triolo G, Cogno C, Amoroso A, Vercellone A. Impact of donor age in kidney transplantation. Transplant Proc 1991; 23: 2620-1.

    PubMed  CAS  Google Scholar 

  34. Bergeron E, Aboujaoude M, Saintlouis G, Corman J, Smeeters C, Daloze P. Necrose tubulaire aigue chez les transplantes renaux: facteurs associes et impact sur la survie fonctionnelle de la greffe. Ann Chir 1995; 49: 674-9.

    PubMed  CAS  Google Scholar 

  35. Feldman HI, Gayner R, Berlin JA, Roth DA, Silibovsky R, Kushner S, et al. Delayed function reduces renal allograft survival independent of acute rejection. Nephrol Dial Transplant 1996; 11: 1306-13.

    PubMed  CAS  Google Scholar 

  36. Cecka JM, Cho YW, Terasaki PI. Analysis of the UNOS scientific renal transplant registry at three years-early events affecting transplant success. Transplantation 1992; 53: 59-64.

    PubMed  CAS  Google Scholar 

  37. Troppmann C, Gillingham KJ, Benedetti E, Almond PS, Gruessner RWG, Najarian JS, et al. Delayed graft function, acute rejection, and outcome after cadaver renal transplantation. Amultivariate analysis. Transplantation 1995; 59: 962-8.

    CAS  Google Scholar 

  38. Merkus JWS, Hoitsma AJ, Koene RAP. Detrimental effect of acute renal failure on the survival of renal allografts: influence of total ischemia time and anastomosis time. Nephrol Dial Transplant 1991; 6: 881-6.

    PubMed  CAS  Google Scholar 

  39. Pirsch JD, D'Alessandro AM, Sollinger HW, Hoffmann RM, Roecker E, Voss BJ, et al. The effect of donor age, recipient age, and HLA match on immunologic graft survival in cadaver renal transplant recipients. Transplantation 1992; 53: 55-9.

    PubMed  CAS  Google Scholar 

  40. Cacciarelli TV, Sumrani N, DiBenedetto A, Hong JH, Sommer BG. The influence of cold ischemia and donor age on renal allograft outcome in the cyclosporine era. Transplant Proc 1992; 24: 2044-5.

    PubMed  CAS  Google Scholar 

  41. Kumar MSA, Stephan R, Chui J, Chvala RP, Brezin J, Katz SM, et al. Donor age and graft outcome in cadaver renal transplantation. Transplant Proc 1993; 25: 3097-8.

    PubMed  CAS  Google Scholar 

  42. Gaber LW, Moore LW, Alloway RR, Amiri MH, Vera SR, Gaber AO. Glomerulosclerosis as a determinant of posttransplant function of older donor renal allografts. Transplantation 1995; 60: 334-9.

    PubMed  CAS  Google Scholar 

  43. Isoniemi H, von Willebrand E, Krogerus L, Taskinen E, Ahonen J, Häyry P. The effect of donor age on kidney graft function and on histopathological findings. Transplant Proc 1992; 24: 328-9.

    PubMed  CAS  Google Scholar 

  44. Cantarovich D, Giral-Classe M, Le Sant JN, Hourmant M, Dantal J, Blancho G, et al. Renal transplantation from cadaver donors over 60 years old. Clin Transplant 1994; 8: 237-42.

    Google Scholar 

  45. Cacciarelli TV, Sumrani N, DiBennedetto A, Goldberg K, Georgi B, Hong JH, et al. Influence of donor age and rejection episodes on renal allograft outcome. Transplant Proc 1993; 25: 2180-2.

    PubMed  CAS  Google Scholar 

  46. Cacciarelli TV, Sumrani N, Scriven R, DiBennedetto A, Hong JH, Sommer BG. Influence of donor and recipient age on renal allograft survival time. Transplant Proc 1993; 25: 3140-2.

    PubMed  CAS  Google Scholar 

  47. Phillips AO, Bewick M, Snowden SA, Hillis AN, Hendry BM. The influence of recipient and donor age on the outcome of renal transplantation. Clin Nephrol 1993; 40: 352-4.

    PubMed  CAS  Google Scholar 

  48. Roels L, Waer M, Coosemans W, Christiaens M-R, Vanrenterghem Y. The influence of donor age on initial and long-term renal allograft outcome. Transplant Int 1994; 7 Suppl 1: 303-5.

    Article  Google Scholar 

  49. Roels L, Vanrenterghem Y, Waer M, Christiaens MGruwez J, Michielsen P. The aging kidney donor: another answer to organ shortage. Transplant Proc 1990; 22: 368-70.

    PubMed  CAS  Google Scholar 

  50. Almond PS, Matas A, Gillingham K, Dunn DL, Payne WD, Gores P, et al. Risk factors for chronic rejection in renal allograft recipients. Transplantation 1993; 55: 752-7.

    PubMed  CAS  Google Scholar 

  51. Längle F, Sautner T, Grünberger T, Götzinger P, Schuster G, Pohanka E, et al. Impact of donor age on graft function in living-related kidney transplantation. Transplant Proc 1992; 24: 2725-7.

    PubMed  Google Scholar 

  52. Fauchald P, Sodal G, Albrechtsen D, Leivestad T, Berg KJ, Flatmark A. The use of elderly living donors in renal transplantation. Transplant Int 1991; 4: 51-3.

    Article  CAS  Google Scholar 

  53. Lezaic V, Djukanovic L, Blagojevic-Lasic R, Radivojevic D, Markovic V, Petronic V, et al. Living related kidney donors over 60 years old. Transplant Int 1996; 9: 109-14.

    Article  CAS  Google Scholar 

  54. Matas AJ, Simmons RL, Kjellstrand CM, Buselmeier TJ, Najarian JS. Transplantation of the aging kidney. Transplantation 1976; 21: 160-1.

    PubMed  CAS  Google Scholar 

  55. Sumrani N, Delaney V, Ding Z, Davis R, Daskalakis P, Tejani A, et al. Renal transplantation from elderly living donors. Transplantation 1991; 51: 305-9.

    Article  PubMed  CAS  Google Scholar 

  56. Mackenzie HS, Azuma H, Rennke HG, Tilney NL, Brenner BM. Renal mass as a determinant of late allograft outcome: Insights from experimental studies in rats. Kidney Int 1995; 48 Suppl. 52: 38-42.

    Google Scholar 

  57. Rosman J, Steinhäuslin F, David S, Genton A, Mosimann F, Wauters J-P. Impact of recipient and donor age on the outcome of renal transplantation. Transplant Proc 1992; 24: 2723-4.

    PubMed  CAS  Google Scholar 

  58. Matas AJ, Gillingham KJ, Sutherland DER. Half-life and risk factors for kidney transplant outcome-importance of death with function. Transplantation 1993; 55: 757-61.

    PubMed  CAS  Google Scholar 

  59. Berthoux FC, Jones EHP, Mehls O, Valderrábano F, on behalf of the EDTA-ERA registry. Transplantation report 1: renal transplantation in recipients aged 60 years or older at time of grafting. Nephrol Dial Transplant 1996; 11 Suppl 1: 37-40.

    PubMed  Google Scholar 

  60. Okiye SE, Engen DE, Sterioff S, Johnson WJ, Frohnert PP, Offord KP, et al. Primary renal transplantation in patients 50 years of age and older. Transplant Proc 1983; 15: 1046-53.

    Google Scholar 

  61. Fauchald P, Albrechtsen D, Leivestad T, Pfeffer P, Talseth T, Flatmark A. Renal replacement therapy in patients over 60 years of age. Transplant Proc 1988; 20: 432-3.

    PubMed  CAS  Google Scholar 

  62. Lundgren G, Fehrman I, Gunnarsson R, Lindholm B, Tillegard A, Öst L, et al. Cadaveric renal transplantation in patients over 55 years of age with special emphasis on immunosuppressive therapy. Transplant Proc 1982; 14: 601-4.

    PubMed  CAS  Google Scholar 

  63. Sommer BG, Ferguson RM, Davin TD, Kjellstrand cm, Fryd DS, Simmons RL, et al. Renal transplantation in patients over 50 years of age. Transplant Proc 1981; 13: 33-5.

    PubMed  CAS  Google Scholar 

  64. Taube DH, Winder EA, Ogg CS, Bewick M, Cameron JS, Rudge CJ, et al. Successful treatment of middle aged and elderly patients with end stage renal disease. Br Med J 1983; 286: 2018-20.

    CAS  Google Scholar 

  65. Hutchinson TA, Thomas DC, Lemieux JC, Harvey CE. Prognostically controlled comparison of dialysis and renal transplantation. Kidney Int 1984; 26: 44-51.

    PubMed  CAS  Google Scholar 

  66. Khan ICH, Catto GR, Edward N, Fleming LW, Henderson IS, MacLeod AM. Influence of coexisting disease on survival on renal-replacement therapy. Lancet 1993; 341: 415-8.

    Article  PubMed  CAS  Google Scholar 

  67. Schaubel D, Desmeules M, Mao Y, Jeffery J, Fenton S. Survival experience among elderly end-stage renal disease patients. Transplantation 1995; 60: 1389-94.

    Article  PubMed  CAS  Google Scholar 

  68. Arbus GS, Rochon J, Thompson D. Survival of cadaveric renal transplant grafts from young donors and in young recipients.Pediatr Nephrol 1991; 5: 152-7.

    Article  PubMed  CAS  Google Scholar 

  69. Ettenger RB, Rosenthal JT, Marik J, Salusky IB, Kamil E, Malekzadeh MH, et al. Successful cadaveric renal transplantation in infants and young children. Transplant Proc 1989; 21: 1707-8.

    PubMed  CAS  Google Scholar 

  70. Peeters J, Roels L, Vanrenterghem Y, for the Leuven Collaborative Group for Transplantation. Chronic renal allograft failure: clinical overview. Kidney Int 1995; 48 Suppl 52: 97-101.

    Google Scholar 

  71. Morris GE, Jamieson NV, Small J, Evans DB, Sir Calne R. Cadaveric renal transplantation in elderly recipients: is it worthwhile. Nephrol Dial Transplant 1991; 6: 887-92.

    PubMed  CAS  Google Scholar 

  72. Benedetti E, Matas AJ, Hakim N, Fasola C, Gillingham K, McHugh L, et al. Renal transplantation for patients 60 years of age or older. Ann Surg 1994; 220: 445-58.

    PubMed  CAS  Google Scholar 

  73. Tesi RJ, Elkhammas EA, Davies EA, Henry ML, Ferguson RM. Renal transplantation in older people. Lancet 1994; 343: 461-4.

    Article  PubMed  CAS  Google Scholar 

  74. Pirsch JD, Ploeg RJ, Gange S, D'Alessandro AM, Knechtle SJ, Sollinger HW, et al. Determinations of graft survival after renal transplantation. Transplantation 1996;11: 1581-6.

    Article  Google Scholar 

  75. Lindholm A, Ohlman S, Albrechtsen D, Tufveson G, Persson H, Persson NH. The impact of acute rejection episodes on long-term graft function and outcome in 1347 primary renal transplants treated by 3 cyclosporine regiments. Transplantation 1993; 56: 307-15.

    PubMed  CAS  Google Scholar 

  76. Yuge J, Cecka JM. Sex and age effects in renal transplantation. Clin Transplant 1991; 5: 257-67.

    Google Scholar 

  77. Filo RS, Book B, Pescovitz MD, Milgrom ML, Leapman SB. Association of sensitization to horse antilymphocyte/ thymocyte globulin with recipient age and decreased renal allograft survival rates. Transplant Proc 1993; 25: 577-80.

    PubMed  CAS  Google Scholar 

  78. Cole E, Farewell VT, Aprile M, Cattran DC, Pei YP, Fenton SS, et al. Renal transplantation in older patients: the University of Toronto experience. Geriatric Nephrology and Urology 1995; 5: 85-92.

    Article  Google Scholar 

  79. Newstead CG, Dyer PA. The influence of increased age and age matching on graft survival after first cadaveric renal transplantation. Transplantation 1992; 54: 441-3.

    PubMed  CAS  Google Scholar 

  80. Morales JM, Campo C, Hernandez E, Andres A, Praga M, Montoyo C, et al. Influence of donor and recipient age on graft survival rate after renal transplantation with a protocol of low CyA doses. Transplant Proc 1991; 23: 2622-3.

    PubMed  CAS  Google Scholar 

  81. Donnelly PK, Simpson AR, Milner AD, Nicholson ML, Horsburgh T, Veitch PS, et al. Age-matching improves the results of renal transplantation with older donors. Nephrol Dial Transplant 1990; 5: 808-11.

    PubMed  CAS  Google Scholar 

  82. Donnelly P, Veitch P, Bell P, Henderson R, Oman P, Proud G. Donor-recipient age difference-an independent risk factor in cyclosporin-treated renal transplant recipients. Transplant Int 1991; 4: 88-91.

    Article  CAS  Google Scholar 

  83. Cecka JM, Terasaki PI. Optimal use for older donor kidneys: older recipients. Transplant Proc 1995; 27: 801-2.

    PubMed  CAS  Google Scholar 

  84. Delmenico F. Discarding the older age kidney: Establishing the need for innovative utilization. XVI International Congress of the Transplantation Society (abstract) 1996; 107.

  85. Gjertson DW. Multifactorial analysis of renal transplants reported to the United Network for Organ Sharing registry. Clin Transplant 1992; 6: 299-317.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine-Nephrology, Medical Clinic V, University Hospital Charité, Humboldt-University of Berlin, Berlin, Germany

    Johannes Waiser, Klemens Budde, Torsten Böhler & Hans-Hellmut Neumayer

Authors
  1. Johannes Waiser
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Klemens Budde
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Torsten Böhler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hans-Hellmut Neumayer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Waiser, J., Budde, K., Böhler, T. et al. The influence of age on outcome after renal transplantation. Geriatric Nephrology and Urology 7, 137–146 (1997). https://doi.org/10.1023/A:1008263727499

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1008263727499

Search

Navigation