Extended Criteria Donor Kidneys an Option for Patients over Age 60
Initiated in February 2003, the extended criteria donor (ECD) program seeks to offer older donor kidneys to older patients on the waiting list in an effort to expedite their transplant. An ECD kidney is defined as a kidney from a donor over age 50 with two of three high risk criteria:
- high blood pressure
- stroke or
- elevated creatinine level.
All transplant candidates over age 60 or those who are diabetic over age 40 are informed about the ECD program at evaluation and encouraged to read related material. The transplant team welcomes questions from patients who want to learn if they would be candidates for the program. Patients who want to pursue an ECD kidney must sign a consent form to go on the list.
“The idea behind this national program is to transplant more marginal kidneys into older recipients in order to shorten their wait time on dialysis,” explains William Bry, M.D., surgical director of California Pacific’s Kidney Transplant Program. “Experience has shown that these kidneys can still function well if care is taken to evaluate each donor’s history, laboratories and sometimes kidney biopsy.”
Fifty-two ECD Kidneys Transplanted at California Pacific
In the first four years of our program, 52 individuals received ECD kidneys at California Pacific. The average age of these recipients was 67 years old, meaning some patients in their mid-70s have received ECD kidneys. “None of these kidneys have been lost to rejection, suggesting that the immune systems of older transplant recipients are tolerant of the new kidney with our current antirejection medications,” says Bry.
Four patient deaths have occurred over the four-year period: two from pneumonia and two from heart attacks. All four patients died with normal renal function. According to Bry, “It appears that older patients are much more likely to die of natural causes following kidney transplantation than of renal failure itself.”
California Pacific’s data shows that excellent renal function is achieved in patients receiving ECD kidneys. The ECD kidneys transplanted at California Pacific are screened carefully to be sure that they will function well in the patients receiving them. The average wait for a donor kidney in northern California is between five and six years. The average wait for the ECD kidney is two and one-half years, thereby enabling a patient over age 60 to cut his/her wait in half by accepting an ECD kidney.
About California Pacific Medical Center
California Pacific Medical Center, part of the Sutter Health network, offers kidney, pancreas, liver and heart transplantation as part of our Barry S. Levin, MD Department of Transplant.
Kidney & Pancreas Transplant Program
California Pacific Medical Center
2340 Clay Street
San Francisco, CA 94115
Tel. 415-600-1700
Outreach locations available throughout Northern California and in Reno.