• Jagbir Gill, Suphamai Bunnapradist, Gabriel M Danovitch, David Gjertson, John S Gill, and Michael Cecka.
• Division of Nephrology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. jsgill2@shaw.ca
• Am. J. Kidney Dis. 2008 Sep 1; 52 (3): 541-52.

BackgroundMore than half the newly wait-listed patients for kidney transplantation in 2005 were older than 50 years, and 13% were older than 65 years. As waiting times for a deceased donor kidney increase, these older candidates are disadvantaged by rapidly deteriorating health, often resulting in death or removal from the wait list before transplantation.Study DesignAn observational cohort study was conducted using data from the Organ Procurement Transplant Network/United Network for Organ Sharing.Setting & ParticipantsAll adult kidney-only transplantations performed in recipients 60 years and older from 1996 to 2005 were included.PredictorThe recipient cohort was stratified into 4 groups based on donor source: older living donor (OLD: living donor age > 55 years), younger living donor (YLD: living donor age Outcomes & MeasurementsEarly posttransplantation outcomes, graft survival, patient survival, renal function 1 year posttransplantation, and relative risk of graft loss and patient death were compared.ResultsOf 23,754 kidney transplantations performed in recipients 60 years and older, 7,006 were living donor transplantations (1,133 were > 55 years [OLD] and 5,873 were LimitationsObservational retrospective studies using registry data are subject to inherent limitations, including the possibility of selection bias.ConclusionsWith superior graft and patient survival in recipients of transplants from OLDs compared with SCDs and ECDs, OLDs may be an important option for elderly transplantation candidates and should be considered for older patients with a willing and suitable older donor.

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