Is Kidney Transplantation Safe in Patients over 71 Years Old?
Department of Kidney & Liver Transplantation, ASUIUD, Udine, Italy.
Meeting: 2018 American Transplant Congress
Abstract number: D297
Keywords: Elderly patients, Graft survival, Kidney transplantation, Outcome
Session Information
Session Name: Poster Session D: Late Breaking
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Introduction: Kidney transplantation in elderly patients is superior over dialysis as therapy for end stage renal disease (ESRD). We analyzed different parameters to evaluate patient and graft survival in recipients from 65 to 76-years old.
Materials and Methods: 109 consecutive first single kidney transplantations (SKTs) were included .Follow-up of 68±49 months was conducted to December 2017.Patients were divided in group A 65-70 vs group B 71-76 years-old,. Age, sex, BMI, hypertension, and diabetes of the donors were included.
The same parameters, plus peripheral vasculopathy, duration-type of dialysis and immunosuppressive therapy were evaluated in the recipients. Cold-warm ischemia time (CIT-WIT), delay graft function (DGF), biopsy proven acute rejection (BPAR)and causes of death were considered. Preimplantation biopsies, were analyzed and graded according to Karpiski classification.
Results: Donors were 44% males, and 56% females respectively, with a mean age of 65±10 years and a mean BMI of 26±4. Recipients were 76 males, and 33 females respectively, with a mean age of 68±3 years-old, a mean BMI of 25±4. Diabetes, hypertension, and peripheral vasculopathy were present in 17%, 49.5%, and 26.6% of recipients.
Hemodialysis was performed in 91% of patients. 15%, 51%, and 34% of the recipients performed dialysis for a period between 1-5, 6-10, and >11 years respectively.
CIT, and WIT were 1097±809 minutes, and 45±16 minutes, whereas DGF, and BPAR were evident in 24.7%, and 11% of recipients respectively.
Overall mortality was 39.4% with a males' vs females' predominance, 76.8% vs 23.2% respectively. Death causes were infections 42%, tumors 23%, cardiovascular disease 14%, cerebral 7%, and unknown 14% of recipients respectively. Infections were the most common cause of death in males (52%), and tumors in females (55%).
At 1, 3, 5, and 10 years overall patient, and graft survival were 89%, 84%, 72%, 45%, and 100%, 97%, 89%, and 84% respectively. P
Despite no differences in donors' characteristics between the two groups, patients' survival was 90%, 85%, 78%, and 54% in group A, and 85%, 80%, 52% e 12% in group B respectively (p=0.006). Graft survival was 100%, 100%, 94%, and 87% in group A, and 100%, 88%, 74%, and 74% in group B respectively (p=0.02).
Conclusions: KT in patients over 65 years is safe, and related with a good graft survival. Patients' mortality and graft loss is statistically higher over 71 years-old.
CITATION INFORMATION: Andani G., Tulissi P., Gropuzzo M., Crestani S., Vallone C., Baccarani U., Montanaro D., Risaliti A. Is Kidney Transplantation Safe in Patients over 71 Years Old? Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Andani G, Tulissi P, Gropuzzo M, Crestani S, Vallone C, Baccarani U, Montanaro D, Risaliti A. Is Kidney Transplantation Safe in Patients over 71 Years Old? [abstract]. https://atcmeetingabstracts.com/abstract/is-kidney-transplantation-safe-in-patients-over-71-years-old/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress