DGF-Associated Mortality Higher in the Elderly

SEATTLE—Delayed graft function (DGF) is associated with an increased risk of death in the early post-transplant period among elderly kidney transplant recipients, data presented at the 2013 American Transplant Congress suggest.

Jagbir Gill, MD, and collaborators at the University of British Columbia in Vancouver examined the effect of DGF on risk of death in the first six months among recipients of deceased-donor kidneys. The researchers stratified patients according to age groups: 18-39 (17,366 patients), 40-49 (18,047 patients), 40-59 (21,333 patients), 60-69 (15,333 patients), and 70 years and older (4,308 patients).

In the age group of recipients aged 70 and older, those with DGF had a 2.2 times increased risk of death compared with those without DGF, after adjusting for donor age, race, gender, recipient race, gender, cause of end-stage renal disease and other potential confounders. By comparison, among recipients aged 60-69, 50-59, 40-49, and 18-39, DGF was associated with a 20%, 18%, 63%, and 64% increased risk of death, respectively, compared with absence of DGF.

“Efforts to minimize DGF are paramount in the management of elderly transplant patients, including counseling of elderly candidates to consider living donor transplantation,” the authors concluded.

Patients older than 65 years accounted for 17.5% of all transplant recipients in the U.S. in 2011, according to Dr. Gill's team. Elderly transplant patients are more likely to receive an expanded criteria donor kidney, which may confer a higher risk of DGF, they noted.

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