A single-center experience of renal transplantation in elderly patients: a paired-kidney analysis

Chronic renal failure is a disease of the elderly. The elderly are the fastest growing population among dialysis patients and also on waiting lists for kidney transplantation. The objective for this study was to analyze the results of the renal transplantation in recipients elder than 60 years. To minimize the donor variability and bias, a paired kidney analysis was used.

The older renal transplantation (ORT) group included 44 patients (30 men, 14 women) aged 60 to 72 (mean 64+/-3) years. Their pairs created a younger renal transplantation (YRT) group consisting of 44 patients (30 men, 14 women) aged 14 to 59 (mean 40+/-12) years.

Graft function estimated 1 year after transplantation applying abbreviated Modification of Diet in Renal Disease formula was significantly better in ORT (46.8+/-10.2 ml/min) versus YRT (43.7+/-16.8 ml/min). Studied groups (ORT vs. YRT) did not differ significantly with respect to 1-year patient survival (93.2% vs. 95.5%), 1-year graft survival (88.6% vs. 86.3%), 1-year death-censored graft survival (93% vs. 90.1%), and the incidences of delayed graft function and acute rejection. The most common complications noticed after ORT were cardiovascular complications, surgical complications, and infections.

Our single-center results confirm that renal transplantation is a good option of renal replacement therapy in patients older than 60 years. Thorough recipient selection and preparation as well as customized immunosuppressive protocols are particularly important in that group of renal transplant recipients.