*Purpose: Donor and recipient pre-transplant risk factors are known to influence post-transplant recipient survival. This study’s purpose was to identify the most important donor and recipient risk factors for mortality in kidney transplant recipients greater than 70 years of age.

*Methods: UNOS/OPTN database was retrospectively queried to identify all kidney transplant recipients from 2000-2016 greater than 70 years of age at time of transplant listing. Recipients were stratified based on donor profile and recipient comorbidities. Kaplan-Meier was applied to calculate patient and graft survival; log-rank test was utilized for significance. Cox proportional hazard regression analysis was performed to identify risk factors associated with lower survival.

*Results: 41,264 patients met the inclusion criteria of kidney transplant listing at greater than 70 years of age: 25,718 patients were waitlisted and never transplanted, and 15,548 patients received a transplant. Mean age at listing was 72.97 ± 2.87 years. Kaplan-Meier curve (Figure 1) demonstrates a survival benefit of kidney transplant from any donor profile over remaining on the waitlist. Living donor transplants in non-dialysis recipients had the longest overall survival (50% at 10 years). Recipients transplanted with any deceased donor within 1 year of transplant listing demonstrated statistically significant increased survival compared to remaining on the waitlist (HR 1.76 vs HR 11.34 respectively, p<0.01). The lowest survival was seen in waitlisted kidney transplant recipients not receiving a transplant.

*Conclusions: Early kidney transplantation regardless of donor profile offers significant survival benefits to transplant candidates over age 70. Recipients over age 70 should be encouraged to utilize living kidney donation when available, but transplant centers should consider all deceased donor profiles in order to facilitate earlier transplantation and improved patient survival.

« Back to 2022 American Transplant Congress