Outcomes in Kidney Transplant Recipients Over Age of 55 by Donor Source: LD, SCD, ECD

V. Kirchner, K. Gillingham, A. Matas, The Div of Tx and Tx Nephrology.

University of Minnesota, Mpls.

Meeting: 2015 American Transplant Congress

Abstract number: A144

Keywords: Donors, Kidney transplantation, marginal, Outcome

Background: Outcomes in older kidney transplant recipients from SCD and ECD have been studied; however, comparative outcomes between older recipients of LD, SCD and ECD kidneys based on recipients age group have not been reported.

Methods: Between 1/1/2000 and 12/31/2013, 666 patients over age of 55 received primary renal transplant (335 LD, 262 SCD, 69 ECD) with minimum follow-up of 22 months. Among the group, 405 (61%) were men and 568 (87%) were Caucasian. We studied subsequent actuarial patient survival (PS), graft survival and death censored graft survival (DCGS) based on recipients age groups (55-60, 61-65, 66-70, >70 years old). Causes of graft loss and death with function were reported.

Results: Preemptive transplants were performed for 218 (67%) LD, 96 (37%) SCD and 25 (36%) ECD recipients. Five-year PS and DCGS are shown in Tables 1 and 2.

Table 1: 5-Year Patient Survival

	55-60 yo	61-65 yo	66-70 yo	>70 yo
LD
# of Patients at Risk (n)	97	65	27	28
PS (%)	89%	90%	75%	65%
SCD
# of Patients at Risk (n)	47	43	36	28
PS (%)	83%	80%	81%	88%
ECD
# of Patients at Risk (n)	11	11	18	11
PS (%)	83%	94%	72%	78%

Table 2: 5-Year Death Censored Graft Survival

	55-60 yo	61-65 yo	66-70 yo	>70 yo
LD
# of Patients at Risk (n)	95	61	29	28
DCGS (%)	93%	90%	94%	94%
SCD
# of Patients at Risk (n)	45	42	36	28
DCGS (%)	92%	93%	88%	97%
ECD
# of Patients at Risk (n)	10	11	18	11
DCGS (%)	83%	92%	96%	84%

In age group >70 yo, 5-year PS was 65% for LD recipients as compared to 88% for SCD recipients (p<0.05). Within individual age groups, there was no statistical difference in DCGS among recipients based on donor type. For all age groups, death with function was major cause of graft loss (50-86%) followed by IF/TA (7-18%); major causes of death with function were cardiovascular disease (19 -50%) and malignancy (10-29%).

Conclusions: Within individual age groups, PS and DCGS were similar between LD, SCD and ECD recipients except for recipients over 70 years old where PS among LD recipients was inferior to SCD recipients. Within individual age groups, major causes of graft loss and death with function were similar regardless of donor type and comparable to general transplant population.

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