Old Age Alone Should Not Prevent Kidney Transplants
MILAN—Elderly individuals should not be disqualified as kidney transplant recipients solely on the basis of age, researchers reported at the 28th annual congress of the European Association Urology.
Niall J. Dempster, MD, and colleagues in the Department of Surgery and Transplantation at Western Infirmary in Glasgow, U.K., reviewed data from 762 renal transplants performed from January 2001 to December 2010. They compared the rate of delayed graft function (DGF) and biopsy-proven acute rejection (BPAR), and other outcomes among elderly patients (older than 65 years) with those among younger patients.
Compared with younger recipients, elderly recipients received a significantly greater proportion of kidneys from elderly donors (27.1% vs. 6.3%). The kidneys from elderly donors were more likely than kidneys from younger donors to result in DGF (40.7% vs. 16.9%) and graft loss at one year (15.3% vs. 7.6%), but did not affect one-year overall patient survival. Recipient age did not affect the DGF rate in the elderly and non-elderly patients (16.9% and 18.5%, respectively) or graft loss at one year (11.9% and 7.8%). Significantly more elderly than non-elderly recipients, however, died in the first year post-transplant (6.8% vs. 2.1%). BPAR occurred significantly less frequently in elderly than non-elderly recipients (6.8% vs. 22%). Although elderly recipients were significantly more likely to be readmitted to a hospital (31.8% vs. 10.9%), age did not significantly influence recipient length of stay.
The researchers observed that the higher readmission rates and mortality in the first post-transplant year may reflect the greater prevalence of co-morbidities in elderly patients.
“Recipient age in isolation should not preclude renal transplantation,” the authors concluded in a poster presentation.