Despite growing access to kidney transplantation, adults older than 65 years are still less likely than younger patients to be waitlisted and receive a first or second kidney, investigators reported at the 2023 American Transplant Congress in San Diego, California.

Using 1995-2018 data from the US Renal Data System, investigators identified 2,495,031 adult patients on dialysis seeking a first kidney transplant and 110,338 adult recipients seeking a second kidney transplant after their initial graft failed.

Patients aged 65 years or older had significant 84% lower odds of being waitlisted for a first transplant and 13% lower odds of receiving one compared with patients aged 18 to 64 years, after adjustment for relevant confounders, Mara A. McAdams DeMarco, PhD, of NYU Langone in New York, New York, and colleagues reported.

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Among patients who experienced graft failure, those aged 65 years or older had a significant 63% lower probability of waitlisting for a second kidney and a 25% lower probability of receiving one compared with the younger patients.

Age disparities in waitlisting were greater for those seeking a first rather than second transplant. The investigators noted that older adults with graft failure are already familiar with transplant procedures. Age disparities in receiving a kidney were similar for seekers of a first or second transplant.

“Transplant centers should be aware of these age disparities and help identify appropriate older patients who would benefit from first and re-KT, regardless of their age,” Dr DeMarco’s team concluded in a study abstract.


Chen Y, Churilla B, Quint E, et al. Age disparities in access to first and repeat kidney transplantation. Presented at: ATC 2023; June 3-7, San Diego, California. Abstract B304.