Kidneys from older donors often do not survive long after transplantation because of certain structural dysfunctions that can occur as the kidney ages, according to a study appearing in the January 2009 issue of the Journal of the American Society Nephrology (JASN). The findings indicate that the number of functioning glomeruli - the filtering units of the kidney - drops significantly with age, leading to a self-perpetuating injury in the rest of the kidney.

Thousands of individuals are on the waiting list for kidney transplants in the United States, and the average waiting time is more than three years. One response to the donor deficit has been to increase the number of transplants from older deceased donors. However, these kidneys exhibit a striking reduction in the 5-year graft survival rate. "We need to understand the process of renal senescence better in order to better select older donor organs that are likely to function well after transplantation," said Jane C.Tan, MD, of the Stanford University Medical Center in Stanford, California.

To understand the aging-related changes in the kidney that account for the shortened survival of older organs, Dr. Tan and her colleagues analyzed the structures of kidneys from 20 aging (>55 years) and 23 youthful (

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