Using them would increase available organs, researchers say,,,,
WEDNESDAY, April 1 (HealthDay News) -- When it comes to kidney donation, you're never too old to give or receive, new research shows.
In a study of kidney transplants from donors who were 70 years old and older, Italian researchers found that after two years, the kidneys appeared to be functioning as well as those from donors who were 10 years younger.
"Ninety-three percent of kidneys from donors over 70 years, and 91 percent of kidneys from donors aged 60 to 69, had grafts [the transplanted organ] that were still functioning at two years after transplantation," said study co-author Dr. Giuseppe Remuzzi, research director of the Negri Bergamo Laboratories at the Mario Negri Institute for Pharmacological Research in Bergamo.
Results of the study were published as a letter in the April 2 issue of the New England Journal of Medicine.
There have been numerous concerns about using organs from older donors, according to Remuzzi. First, doctors worried that kidneys from old or very old donors might not function as long as kidneys from younger donors. Older kidneys would also be more likely to have narrowing of the arteries, which could lead to more surgical complications. And, if there were more surgical complications, that would mean the recipient would need to be under anesthesia for a longer period of time, which would increase risks for the recipient, he explained.
There were also concerns that doing a pre-implantation biopsy, which is necessary to ensure a good match between donor and recipient, might damage an older kidney. Finally, there were also concerns that an older kidney wouldn't be viable for as long between removal and transplant.
But, Remuzzi said a pilot study done 10 years ago found that kidneys from older donors survived well throughout the transplant process. Building off that work, the Italian researchers compared transplant results from 71 people who received one or two kidneys from donors older than 70 to the results of 67 people who received kidneys from people between 60 and 69 years old.
The average age of the recipients was 60, but ranged from 38 to 72 years. Remuzzi said that doctors usually try to keep the age of the donor and recipient to within 10 years. However, there are people who can be difficult to match for blood types and other factors, and doctors may need to use a non age-matched donor for that recipient.
Over an average two-year follow-up period, the researchers found little difference between the two groups of recipients. The group that received kidneys from those over 70 actually fared slightly better in terms of kidney function and survival.
"More than 20 percent of over-65-year-old transplant candidates die every year in the U.S.," said Remuzzi. "Since the survival rate of elderly recipients of a kidney graft is more than double compared to that of age-matched patients remaining on dialysis, accelerating the access to kidney transplant is also expected to extend the life expectancy of this population."
Dr. Mohamed El-Ghoroury is director of transplant services at St. John Hospital and Medical Center in Detroit. He said, "In the U.S., it's very rare to use organs from patients over 70. But, as a clinician, this study may make me look more. The transplant list keeps increasing, and people are dying on the waiting list. In this study, the two-year survival rates were encouraging.
"I think the community in general should know that they don't have to give up on the idea of donation, even if their family member is over 70. They can still save the lives of other people even if they're over 70," he added.
To learn more about kidney transplantation, visit the National Kidney Foundation.
SOURCES: Giuseppe Remuzzi, M.D., research director, Negri Bergamo Laboratories at the Mario Negri Institute for Pharmacological Research, Bergamo, Italy; Mohamed El-Ghoroury, M.D., director, transplant services, St. John Hospital and Medical Center, Detroit; April 2, 2009, New England Journal of Medicine
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