AUTHOR=Toapanta Néstor , Comas Jordi , Revuelta Ignacio , Manonelles Anna , Facundo Carme , Pérez-Saez María José , Vila Anna , Arcos Emma , Tort Jaume , Giral Magali , Naesens Maarten , Kuypers Dirk , Asberg Anders , Moreso Francesc , Bestard Oriol ,  the EKITE consortium 

TITLE=Benefits of Living Over Deceased Donor Kidney Transplantation in Elderly Recipients. A Propensity Score Matched Analysis of a Large European Registry Cohort

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.13452

DOI=10.3389/ti.2024.13452

ISSN=1432-2277

ABSTRACT=Despite kidney transplantation from living donors (LD) offers better long-term results than from deceased donors (DD), elderly recipients receive LD transplants less frequently than younger ones. We analyzed renal transplant outcomes from LD versus DD in elderly recipients with a propensity matched score. This retrospective, observational study included first single kidney transplants in recipients aged ≥65 years from two European registry cohorts (2013-2020, n=4257). Recipients of LD (n=408), brain death donors (BDD, n=3072), and controlled cardiocirculatory death donors (cDCD, n=777) were matched by donor and recipient age, sex, dialysis time and recipient diabetes. Main graft and patient outcomes were investigated. Unmatched analyses showed LD recipients were more frequently transplanted preemptively and had shorter dialysis time than any DD type. Propensity score matched Cox's regression analysis between LD and BDD (387-pairs) and LD and cDCD (259-pairs) revealed a higher hazard ratio of graft failure among , p=0.016) and cDCD (3.38 [95% CI: 1.79-6.39], p<0.001). One-year eGFR was higher in LD transplants than in BDD and cDCD recipients. In elderly recipients, LD transplant offers superior graft survival and renal function compared to BDD or cDCD. This strategy should be further promoted to improve transplant outcomes.