Renal transplantation in the elderly: a long-term, single-centre experience

Area of Science:

• Nephrology
• Transplantation Immunology
• Geriatric Medicine

Background:

• End-stage renal failure (ESRF) prevalence increases with age.
• Renal transplantation is a key treatment for ESRF, particularly in older adults.
• Limited data exists on long-term outcomes for elderly kidney transplant recipients.

Purpose of the Study:

• To evaluate long-term patient and graft survival in renal transplant recipients over 60 years old.
• To compare outcomes between older (>60) and younger (<60) kidney transplant recipients.
• To identify factors influencing graft survival and mortality in elderly transplant patients.

Main Methods:

• Retrospective analysis of 310 renal transplantations performed between 1983 and 1999.
• Comparison of outcomes in 48 patients aged >60 years versus younger patients.
• Analysis of actuarial patient/graft survival, serum creatinine, graft loss, and mortality causes at 1, 5, and 10 years.

Main Results:

• Ten-year patient survival was 44% for >60 group vs. 81% for <60 group.
• Ten-year graft survival was 32% for >60 group vs. 59% for <60 group.
• Graft survival (censored for death with functioning graft) was 81% for >60 vs. 65% for <60, indicating excellent graft function in survivors. Cardiovascular events, neoplasia, and sepsis were primary mortality causes in older patients. Recipient and donor age were not predictive of graft survival.

Conclusions:

• Renal transplantation offers excellent graft survival in patients over 60.
• Elderly patients benefit significantly from renal transplantation, similar to younger recipients.
• Consideration of renal transplantation in patients >60 is warranted despite shorter life expectancy.