Outcome after renal transplantation utilizing octogenarian donors– retrospective single-center analysis within the Eurotransplant region

Abstract Background A severe shortage of donors and organs remains the primary challenge in modern transplantation medicine. For kidney transplantation, prolonged time on the waiting list increases morbidity and mortality, particularly among elderly patients. Dedicated allocation initiatives, such as the Eurotransplant Senior Program (ESP), were established to shorten waiting times, and previous age limits for organ acceptance were raised to expand the donor pool for this specific patient population. Methods This retrospective study evaluated all patients who received a kidney graft from an octogenarian donor between January 2006 and September 2023. Key outcomes assessed included patient survival, graft survival, and graft function. Results A total of 71 kidney transplantations were included. Primary non-function occurred in five patients, and nine patients experienced delayed graft function. The 5-year recipient survival rate was 68.8%, and the 5-year death-censored graft survival rate was 65.3%. Graft function, assessed via median serum creatinine levels, remained stable throughout the follow-up period, although median creatinine values did not return to the normal range. Conclusions Following meticulous donor selection, allocating kidney grafts from donors aged 80 years or older represents a viable strategy to expand the donor pool for ESP patients.