ORIGINAL RESEARCH
Transpl. Int.
Donor Characteristics Associated With Graft Loss and Delayed Graft Function in Very-Aged Kidney Donors: An Observational Multicentric Study
- MM
Mehdi Maanaoui 1
- RL
Rémi Lenain 1
- VP
Vivien Petit 1
- AD
Amaury Dujardin 2
- EM
Emmanuel Morelon 3
- XC
Xavier Charmetant 3
- ML
Moglie Le Quintrec 4
- JE
Jean Emmanuel Serre 4
- ML
Marc Ladrière 5
- SG
Sophie Girerd 5
- CM
Christophe Masset 2
- AS
Antoine Sicard 6
- CG
Clément Gosset 6
- AH
Aghilès Hamroun 1
- CK
Clarisse Kerleau 2
- CG
Claire Garandeau 2
- FP
François Provôt 1
- MG
Magali Giral 2
- MH
Marc Hazzan 1
1. Centre Hospitalier Regional et Universitaire de Lille, Lille, France
2. Centre Hospitalier Universitaire de Nantes, Nantes, France
3. Centre Hospitalier Universitaire de Lyon, Lyon, France
4. Centre Hospitalier Universitaire de Montpellier, Montpellier, France
5. Centre Hospitalier Universitaire de Nancy, Nancy, France
6. Centre Hospitalier Universitaire de Nice, Nice, France
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Abstract
This study explores the impact of using kidneys from very-aged donors to address the organ shortage, focusing on risk factors for graft loss and delayed graft function (DGF), independent of recipient factors. Data were sourced from the French multicentric prospective DIVAT cohort. The study included adult recipients transplanted between 2007 and 2018 receiving kidneys from brain-deceased donors over 70. The primary endpoint was death-censored graft survival. The secondary outcome was DGF. Among 1036 patients with a median follow-up of 3.96 years (2.01 - 6.31), donor hypertension and cold ischemia time were significant risk factors for graft loss (HR of 1.46 95%CI(1.09 – 1.95) and 1.03 per hour 95%CI (1.01 – 1.06)). Considering DGF, donor serum creatinine (HR 1.01 95%CI (1.01 – 1.01) per μmol/l), warm and cold ischemia times (HR 1.01 95%CI (1.0 – 1.01) per minutes and HR 1.05 95%CI (1.02 – 1.08) per hour) and the use of SCOT preservation solution (HR 3.90 95%CI (1.26 – 11.84)) were deleterious, while hypothermic perfusion machine was protective (HR 0.65 95%CI (0.43 – 0.99)). The findings emphasize the paucity of donor-related variables associated with long-term outcomes in very-aged donors and highlights the need for peri-transplant preservation strategies for this specific population.
Summary
Keywords
Aging, Elderly, kidney transplantation, donor, Preservation
Received
05 May 2025
Accepted
28 October 2025
Copyright
© 2025 Maanaoui, Lenain, Petit, Dujardin, Morelon, Charmetant, Le Quintrec, Serre, Ladrière, Girerd, Masset, Sicard, Gosset, Hamroun, Kerleau, Garandeau, Provôt, Giral and Hazzan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Mehdi Maanaoui, mehdi.maanaoui@chu-lille.fr
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