Renal transplantation in patients over 55 years old

From 1975 to 1987, 507 patients, of whom 63 (12.4 per cent) were over 55 years old at the time of operation, received first cadaver renal transplants. The annual percentage of recipients given transplants after the age of 55 has risen from 0 per cent in 1975 to 44 per cent in 1987. Of the 63 older patients, 41 had at least one serious non-renal disease at the time of transplantation. Perioperative mortality rate was 3 per cent. After successful transplantation these patients remained subject to a significant number of serious complications, even in the cyclosporin era. Despite these adverse factors, actuarial graft survival for the population over 55 years of age was no worse than for those patients receiving first cadaver grafts who were under 55 years old, although patient survival was poorer in the former group (P = 0.027). Analysis of the subgroup of 56 patients treated with an immunosuppression protocol containing cyclosporin failed to show any adverse effect of age on either graft or patient survival. It is concluded that renal transplantation can be as successful in patients over 55 years of age as it is in younger patients and, given an adequate supply of kidneys, should be considered the treatment of choice for the elderly patient with end-stage renal failure.