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Related Experiment Videos

Do elderly patients deserve a kidney graft?

P Nunes1, A Mota, B Parada

  • 1Department of Urology and Renal Transplantation, Hospitais da Universidade de Coimbra, Coimbra, Portugal. pedro.nunes@sapo.pt

Transplantation Proceedings
|September 27, 2005
PubMed
Summary

Older adults (60+) undergoing renal transplantation show similar graft survival rates when death with a functioning graft is excluded. Selected older patients benefit from kidney transplants, similar to younger recipients.

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Area of Science:

  • Nephrology and Transplant Surgery
  • Geriatric Medicine
  • Immunology

Background:

  • Renal transplantation is a life-saving treatment for end-stage renal disease (ESRD).
  • Patient selection criteria for renal transplantation are evolving, with increasing consideration for older adults.
  • Long-term outcomes in elderly renal transplant recipients require further investigation.

Purpose of the Study:

  • To compare long-term renal transplant outcomes between recipients aged 60 years or older and younger patients (18-59 years).
  • To identify factors influencing graft and patient survival in older renal transplant recipients.

Main Methods:

  • Retrospective analysis of 103 renal transplants in recipients aged 60+ years.
  • Comparison with 1060 renal transplants in recipients aged 18-59 years.

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  • Evaluation of graft and patient survival, initial graft function, acute rejection rates, and serum creatinine/clearance.

    • Main Results:

    • Older recipients (60+) had higher prevalence of obesity, unknown ESRD etiologies, and comorbidities, particularly cardiovascular disease.
    • Donor age, cold ischemia time, and HLA compatibility were significantly greater in the older group.
    • No significant differences were observed in initial graft function, acute rejection rates, or serum creatinine/clearance between groups.
    • Overall patient and graft survival rates were lower in the 60+ group.
    • Graft survival censored for death with a functioning graft was comparable between groups (95.1%, 89.4%, 81.2% for 60+ cohort at 1, 5, 10 years).
    • The primary cause of graft loss in older recipients was death with a functioning graft.

    Conclusions:

    • Renal transplantation is a viable option for selected patients over 60 years old.
    • Despite shorter life expectancy, older recipients experience comparable graft survival when accounting for death with a functioning graft.
    • These findings support the consideration of renal transplantation in older adults to improve quality of life and long-term outcomes.