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In 2002, extended criteria donors were the focus of a meeting in Crystal City (VA, USA), with a goal of maximizing the use of organs from deceased donors. Since then, extended criteria donors have progressively contributed to a large number of transplanted grafts worldwide, posing specific issues for allocation systems, recipient management, and therapeutic approaches. This review analyzes what we have learned in the last 20\u00a0years about extended criteria donor utilization, the promising innovations in immunosuppressive management, and the molecular pathways involved in the aging process, which constitute potential\u00a0targets for novel therapies.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s40620-024-01888-w","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T10:03:47Z","timestamp":1709719427000},"page":"1449-1461","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Kidney transplants from elderly donors: what we have learned 20\u00a0years after the Crystal City consensus criteria meeting"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6387-5005","authenticated-orcid":false,"given":"Alberto","family":"Mella","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruggero","family":"Calvetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Barreca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Congiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7700-6350","authenticated-orcid":false,"given":"Luigi","family":"Biancone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,6]]},"reference":[{"key":"1888_CR1","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.2215\/CJN.06100617","volume":"12","author":"C Rose","year":"2017","unstructured":"Rose C, Gill J, Gill JS (2017) Association of kidney transplantation with survival in patients with long dialysis exposure. 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