November 14, 2011
Finding: Healthy people over 70 can safely donate a kidney
Kidney transplants performed using organs from live donors over the age of 70 are safe for the donors and lifesaving for the recipients, new Johns Hopkins research suggests. The study shines new light on a long-ignored potential source of organs that could address a profound national shortage.
Although the study found that kidneys from older donors were more likely to fail within 10 years of transplant when compared with kidneys from donors ages 50 to 59 (33.3 percent failure rate vs. 21.6 percent), patients who received older donated kidneys were no more likely to die within a decade of transplantation than those whose kidney donors were between 50 and 59.
“A lot of people come up to me and say, ‘I wish I could donate a kidney, but I’m too old,’ ” said Dorry Segev, an associate professor of surgery at the Johns Hopkins University School of Medicine. “What our study says is that if you’re in good health and you’re over 70, you’re not too old to donate a kidney to your child, your spouse, your friend, anybody.
“It’s better if you have a younger donor,” Segev acknowledged, “but not everyone has a younger donor. And an older live donor is better than no live donor at all.”
A report on Segev’s research, published online in the Clinical Journal of the American Society of Nephrology, describes analysis of records from the 219 living people over 70 who donated a kidney in the United States between 1990 and 2010. The team matched those donors with healthy people in the same age group and found that the donors actually lived longer than those who had both their kidneys.
Segev attributes the longevity to the probability that people who donated kidneys are healthy to begin with or surgeons wouldn’t allow them to give up an organ. Also, after donation, they may be more likely than the typical person their age to regularly visit a physician and work hard to stay healthy.
More than 90,000 patients are on the waiting list for kidneys from deceased donors in the United States, and many die waiting for an organ to become available. In some parts of the country, the wait for a kidney can be as long as 10 years, and those who can often turn to living donors, both relatives and friends, to ask for organs. People can function normally with one working kidney.
For many people the option may be either to wait as long as 10 years—with a high risk of death during that period—or to find a living donor, even if that donor is over 70, Segev said. A kidney from a living donor over the age of 70 is likely to last as long as a kidney from a younger deceased donor, he said, “and the transplant can occur right away rather than 10 years from now.”
People over the age of 70 make up only a small percentage of live donors, but Segev said that their numbers have been steadily rising, tripling in the past 20 years.
Segev said he hopes that this research will help older people understand that age may not be a barrier to organ donation.
“There are many healthy older adults out there who have loved ones in need of a kidney but are not aware they may be able to donate,” he said. “It is reasonable for them to pursue donation and, if they are cleared by a transplant center, it is safe for them to undergo donation.”
Other Johns Hopkins authors contributing to the study are Jonathan C. Berger, Abimereki Muzaale, Jacqueline M. Garonzik Wang, Robert A. Montgomery, Allan B. Massie and Erin C. Hall.