*Purpose: Patients older than 70 years are the fastest-growing age group of patients requiring renal replacement therapy. This has resulted in a corresponding increase in the number of elderly transplant recipients. In this retrospective, single-center data study, we analyzed the outcomes of kidney transplant recipients aged 70 and more.

*Methods: This study included all kidney transplant recipients performed at our center between Nov 2006 and Nov 2019 who were 70 years or more at the time of their transplant. Donor and recipient characteristics, perioperative complications, delayed graft function, length of stay, rejection episodes, cancer incidence, patient and graft survival were assessed.

*Results: In the study period, 59 recipients underwent kidney transplantation. Five patients that were lost to follow-up within the first year post-transplant were excluded from the study. The majority of transplant recipients were male (61%), white (65%), and less likely to have functional status at listing less than 70% that accounts for caring for self, unable to carry on normal activity or active work (3.7%). The mean age and BMI of the transplant recipients were 73 years and 28 respectively. 37 recipients (69%) received a deceased donor kidney transplant (DDKT). Donor kidneys in the DDKT group had a mean age of 38 years, KDPI of 50%, and cold ischemic time of 17.5 hours. In comparison, donor kidneys in the living donor kidney transplant (LDKT) group were slightly older (mean age of 47 years) and had a significantly lower CIT of 0.8 hrs. Delayed graft function and mean duration of hospital stay were higher in the DDKT group (24% and 9.7) vs (12% and 7.4 days) in the LDKT group. The vast majority (88.46%) of the recipients were consuming >/= 5 pharmacological agents before their transplant, and 50% were at least on one blood thinner medication. Postoperatively, 8% of the recipients developed atrial fibrillation, 4% developed hypotension, and 2% developed an MI. The reoperation rate was 14%. Readmission rates at 30 days and first-year post-transplant were 27% and 46% respectively. 51.92% of recipients developed an infection (bacterial or viral) and 1.92% developed cancer (of any type) within 1 year of their transplant. Rejection within 1 year was seen in 9.61% of the recipients. 17 out of the 19 deceased recipients (89.4%) had a functioning allograft at the time of death. Graft survival at 1,3,5 and 10years was 93%,79%,64% and 28%. Patient survival at 1,3,5 and 10years was 94%,85%,77% and 45%.

*Conclusions: We report encouraging short-term graft and patient survival in elderly kidney transplant recipients. Transplant centers should anticipate longer hospital stays and increased readmission rates in this patient subset.

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