Older kidney donors enjoy similar longevity and cardiovascular health as other healthy mature individuals, according to a new study published in the American Journal of Transplantation. The findings may provide some reassurance to older individuals considering donation and the transplant professionals caring for them.
Over the past two decades, live kidney donation by individuals aged 55 years and older has become more common. Given the links between older age, kidney disease, and heart disease, the removal of a kidney could make older donors vulnerable to premature death and cardiovascular events. In the first study to look closely at the safety of donating for older kidney donors, Peter Reese, MD, MSCE, assistant professor of Medicine in Renal- Electrolyte and Hypertension Division, and director of Kidney Transplant Outcomes Clinical Research at the Perelman School of Medicine at the University of Pennsylvania, and his colleagues matched 3368 older donors 1:1 to older healthy non-donors and followed them for a median of 7.8 years. The researchers found that mortality rates were not different between donors and matched pairs. Also, among donors with Medicare, death or cardiovascular disease rates were similar between donors and non-donors. Donors also did not have an elevated risk of diabetes, a risk factor for cardiovascular and kidney diseases, compared with matched non-donors.
"For too long, when we counseled older people who were considering kidney donation, we were not able to give them good information about their future risk of heart disease. The problem was that prior studies that examined cardiovascular outcomes did not have many older donors," said Dr. Reese. "Now we have a reassuring answer. Transplant centers everywhere should provide this new information to older individuals considering kidney donation. These individuals should learn that donation is unlikely to increase their risk of death or heart disease in a meaningful way." Dr. Reese noted, however, that this information must be provided along with information from other important studies on risks of kidney donation. For example, older donors must be prepared for a recovery period after surgery, they must consider the risk of short-term complications like hernias, and they must also understand that they face a small risk that they might need dialysis one day themselves.
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"Mortality and Cardiovascular Disease among Older Live Kidney Donors." Peter Reese, Roy Bloom, Harold Feldman, Paul Rosenbaum, Wei Wang, Philip Saynisch, Nicole Tarsi, Nabanita Mukherjee, Amit Garg, Adam Mussell, Justine Shults, Orit Even-Shoshan, Raymond Townsend, and Jeff Silber. American Journal of Transplantation; Published Online: July 9, 2014. DOI: 10.1111/ajt.12822