Kidney Donation Is Safe for Healthy Older Adults

For carefully selected adults aged 55 or older, the risks of cardiovascular disease (CVD) and mortality after living kidney donation are no higher than in healthy nondonors, according to a study in the American Journal of Transplantation.

The researchers identified 5152 patients who were 55 or older at the time of donor nephrectomy between 1996 and 2006. Of these, 3368 donors were matched to the same number of healthy nondonors drawn from the longitudinal Health and Retirement Study. The mean age was 59 years, 41 percent of donors were male, and 7 percent were African American.

At a median follow-up time of 7.8 years, mortality was not significantly different between groups: 4.9 deaths per 1000 person-years in living kidney donors and 5.6 per 1000 in nondonor control individuals. In an analysis of 1312 matched pairs with Medicare coverage, the groups were also similar on a combined outcome of time to death or CVD.

There was no increase in risk of diabetes among donors. In a subset analysis of pairs aged 60 or older, mortality was slightly lower for donors: hazard ratio 0.68.

Over the past 2 decades, living kidney donation by adults aged 55 or older has become more common. The new study is one of the first to focus on the safety outcomes for older kidney donors.

The results show similar risks of mortality and CVD for older living kidney donors and nondonor control individuals. The researchers conclude, “In the context of careful medical evaluation and selection, older donors should expect similar medium-term survival and risk of CVD compared to healthy members of the general population” [Reese P, et al. Mortality and cardiovascular disease among older live kidney donors. Am J Transplant July 9, 2014. doi: 10.1111/ajt.12822].