Chesnaye NC, et al. - This study analyzed the association of donor–recipient age combinations with graft survival in children. Excellent graft outcomes were seen in all children who received donations from older living donors. Notably, the allocation of deceased donors (DDs) over the age of 5 years should be prioritized for young recipients.

Methods

• This study used data from the ESPN/ERA-EDTA Registry on 4686 first kidney transplantations performed in 13 countries in 1990–2013.
• Using Kaplan–Meier survival curves and Cox regression, the effect of donor and recipient age combinations on 5-year graft-failure risk, stratified by donor source, was estimated, while adjusting for sex, primary renal diseases with a high risk of recurrence, pre-emptive transplantation, year of transplantation and country.

Results

• Findings demonstrated similar risk of graft failure among older living donors (50–75 years old) and younger living donors {adjusted hazard ratio [aHR] 0.74 [95% confidence interval (CI) 0.38–1.47]}.
• A non- linear association was observed between deceased donor (DD) age and graft survival, with the highest risk of graft failure found in the youngest donor age group [0–5 years; compared with donor ages 12–19 years; aHR 1.69 (95% CI 1.26–2.26)], especially among the youngest recipients (0–11 years).
• Additionally, DD age had little impact on graft failure in recipients’ ages 12–19 years.