Kidney transplantation in the older patient

To determine renal transplant outcome in older patients, 26 consecutive primary kidney allograft recipients aged 50-76 (mean 58) were followed from three to 50 months. Azathioprine, prednisone, and cyclosporine were used in all cases and OKT3 induction in cadaveric grafts. Four patients died at three, 15, 20, and 24 months from infection, hepatic cancer, trauma, and myocardial infarction respectively; each had life-sustaining graft function at final hospital admission or death (one year actuarial patient survival 96.2%). One patient lost a kidney to accelerated acute rejection (one year immunologic graft survival 96.2%) and 11 others (42.3%) experienced acute rejection episodes which were uniformly reversed. Older patients tolerate multidrug immunosuppression, demonstrate acceptable patient survival and good rehabilitation potential, have a low incidence of rejection, and maintain excellent graft function. Renal transplantation is effective and safe renal replacement therapy for patients over age 50 years.