Introduction: Organ transplantation improves the quality of life and increases the life expectancy of patients with end-stage organ failure. The demand of organs for transplant is continually increasing given the aging population, an increase in the prevalence of kidney failure, and advances in intensive care units. In Spain, more than a decade ago, controlled asystole donation (CAD) emerged as a strategy to solve the shortage of organs available for transplant. Although there is not an established age limit in controlled asystole donors, there exists an “unconscious bias” to reject asystole organs by age criteria, without doing a global valuation of the same donors. The main objective of this study is to determine if CAD in patients over 70 years of age is feasible in terms of the effectiveness of the donation and number of organs per real and used donor.

Methods: Retrospective observational study including donors in controlled asystole older than 70 years from November 2014 to September 2021 in a tertiary care hospital.

Results: During the study period, a total of 51 real controlled asystole donors were collected. Of the sample studied, the median age was 74 years, being mostly men (60.1%). Regarding cardiovascular risk factors, 62.7% patients suffered from arterial hypertension, 23.5% from diabetes, 19.6% from dyslipidemia. The most frequent blood type included was 0+ (47,1%) followed by A+ (39.2%), B+ (11.7%) and 0- (2%). The average length of stay in the critical care unit before donation was 7.6 days. The analysis of the data showed an effectiveness of 88.2%, 45 donors used out of the total number of patients included. A total of 37 livers and 40 kidneys were valid and transplanted in their appropriate receptors. In 47.1% of the total of sample it was possible to use one organ, in 19.6% two organs and in 21.6% three organs, assuming a rate of 1.51 organs per real donor and 1.71 in used donor.

Conclusion: The effectiveness of the CAD in this age group is high (88.2%), slightly above the Spanish average in 2020 (87%). Although the rate of organs per donor is low, it exceeds 1.5 organs by transplanted donor. That, in our opinion, is enough to not dismiss a potential controlled asystole donor based solely on age criteria.