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Cadaveric renal transplantation in elderly recipients: is it worthwhile?
G E Morris1, N V Jamieson, J Small
1Department of Surgery, Cambridge University Medical School, Addenbrooke's Hospital, UK.
Summary
Old age alone does not significantly impact graft survival in cadaveric kidney transplants. However, patient survival is lower in older recipients, necessitating careful selection for elderly kidney transplant candidates.
Area of Science:
- Nephrology
- Transplantation immunology
- Geriatric medicine
Background:
- Increasing demand for donor organs in the UK.
- Need to evaluate age as a selection criterion for renal transplantation.
- Limited data on outcomes for elderly kidney transplant recipients.
Purpose of the Study:
- To determine if advanced age impacts patient and graft survival in cadaveric renal transplantation.
- To assess the suitability of age as a selection criterion for kidney transplant programs.
Main Methods:
- Retrospective analysis of 307 solitary cadaveric renal allografts.
- Patients divided into two age groups: <60 years and ≥60 years.
- Comparison of graft and patient survival rates between the groups.
Main Results:
- No significant difference in graft survival (60.3% vs. 62.2%) between younger and older patients.
- Significantly lower patient survival in the ≥60 years group (64.4% vs. 83%, P<0.01).
- Graft loss from rejection in older patients associated with high mortality.
Conclusions:
- Age alone is not a contraindication for renal transplantation but requires careful patient selection.
- Elderly recipients may benefit from adjusted immunosuppression protocols.
- Pre-transplant assessment for cardiovascular disease and thorough risk counselling are crucial for elderly kidney transplant candidates.