AGE-MATCHING IMPROVES THE RESULTS OF RENAL-TRANSPLANTATION WITH OLDER DONORS

Whilst HLA matching is routine for renal transplantation, the possible benefits of matching donor and recipient age have not been previously examined. In this study we examined the simultaneous effect of donor to recipient age difference on the graft survival of 141 consecutive first cadaver transplant recipients treated by cyclosporin immunosuppression. Multivariate regression analysis, taking into account other variables of moderately matched recipients (i.e. dialysis time and type, donor/recipient sex, local/imported kidneys, recent sensitivity, total ischaemic time, preoperative transfusions), indicated that age-difference was the single most important variable (P<0.05). Individually there was no significant effect of recipient age, whilst older donors (aged >50 years) were associated with significantly worse graft survival than those younger (P<0.01). When dealing with donors aged ≥50 years the corresponding recipient 1-year graft was improved when the donor was no more than 5 years older than the transplant recipient. Donor age to recipient age difference is a potentially important selection criterion in renal transplantation. © 1990 European Dialysis and Transplant Association-European Renal Association.