#4617 THE IMPACT OF DONOR NEPHRECTOMY ON THE ELDERLY LIVING KIDNEY DONORS

Abstract Background and Aims Because of the serious cadaveric donor shortage, the number of living donor kidney transplantation (LDKT) is increasing. To increase the living donor (LD) source, elderly LDs are indicated for the donor nephrectomy. However, the safety of the LDs ≥ 70 years is still remained to be investigated. Method Bewteen January 2008 and December 2020, a total 1226 LDs for LDKT was included in this retrospective cohort study. LDs were stratified into 3 groups based on age; 244 LDs aged 30-49 years, 803 LDs aged 50-69 years, 179 LDs aged 70-89 years. To investigate the safety of donor nephrectomy in the LDs ≥ 70 years, operative outcomes, the estimated glomerular filtration rate (eGFR) changes, end stage renal disease (ESRD), and mortality were investigated among 3 groups. eGFR changes were analyzed using mixed linear models. The contributing factors for the recovery in the eGFR from the nadir eGFR were analyzed using multivariate linear regression analysis adjusted for mixed linear models. Mortality rates were analyzed using Cox regression models. Results In the LD characteristics, significant difference was identified in sex. In the operative outcomes, significant difference was not identified in operative duration,blood loss, and complications among 3 groups. In the mixed linear models adjusted for sex, eGFRs of LDs aged 70–89 years were significantly lower at any time points after donor nephrectomy than those in 2 other groups (Figure 1). The eGFR after donor nephrectomy recovers with time in 3 groups. The recoveries in the eGFR from the nadir eGFR were similar among 3 groups. The recoveries in the eGFR were independently affected by the hypetension (P = 0.008), smoking history (P < 0.001), and body mass index (P = 0.011) at donor nephrectomy. Donor age was not the independent factor. The mortality rate of LDs aged 70-89 years was significantly higher than those in 2 other groups (Figure 2). However, during the observational period, ESRD was not identified among 3 groups. Conclusion eGFR changes and mortality rate were significantly low in LDs aged 70-89 years. However, the recoveries in the eGFR from the nadir eGFR were similar among 3 groups. ESRD was not identified among 3 groups. These results implied that LDs aged 70–89 years might undergo donor nephrectomy safely and complete their lives without ESRD after donor nephrectomy.