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Kidney Week

Abstract: TH-PO1154

Is Age Just a Number? Outcomes of Older Living Donors for Pediatric Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Levea, Swee-Ling, University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Macconmara, Malcolm, University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Hwang, Christine S., University of Texas Southwestern Medical Center, Dallas, Texas, United States
Background

Living donor kidney transplantation is encouraged in the pediatric population due to better long term allograft survival compared to deceased donor kidney transplantation. Often, pediatric recipients are listed inactive while awaiting evaluation of their living donors. However, there are limited data addressing the impact of age on allograft survival from living donor. We therefore examined the association of living donor-recipient age combinations with allograft survival in children.

Methods

Using the Scientific Registry of Transplant Recipients (SRTR), we analyzed graft survival among living donor kidney transplant pediatric recipients from older living donors (≥50 years old) compared to younger donors (< 50 years old) between 1993 - 2017. Statistical analysis was performed using STATA and a p value of <0.05 was considered to be significant.

Results

The age of the younger living donors was 35.4 ± 7.6 years while that of the older living donors was 53.4 ± 3.6 years (p< 0.05). The pre-operative creatinine for the younger donors was 0.86 ± 0.34 mg/dL vs. 0.89 ± 0.19 mg/dL for the older donors (p=NS). The average post-operative creatinine for the younger donors was significantly lower at 1.26 ± 0.42 mg/dL while that of the older donors was 1.34 ± 0.30 mg/dL (p<0.05). The BMI, presence or absence of hypertension or diabetes, and cigarette use were not significantly different between the two groups. The HLA mismatch in younger donors was 2.6 ± 1.2 and 2.8 ± 1.3 in the older donors (P<0.05). The allograft survival from younger living donors were superior compared to those from older donors (Figure 1) (p<0.05).

Conclusion

Allograft survival from younger living donors is superior at ten years compared to older living donors. In potential pediatric kidney transplant recipients on the wait-list, deceased donor kidney transplant consideration is beneficial if these individuals have older living donors.