We retrospectively reviewed outcomes in adult patients (pts) 75 years receiving deceased donor kidney transplants (KTs) at our center. Results: We performed 46 KTs in 45 pts age 75 (mean 77 years, range 75-84). The pt group included 22 women and 16 black with a mean waiting time of 13 months and dialysis vintage of 31 months. 31 pts (67%) received kidneys from expanded criteria donors (ECDs), 5 pts received dual kidney transplants, and 3 were retransplants. The incidence of DGF was 22%. With a mean follow-up of 27 months, actual pt and kidney graft survival rates were 85% and 76%, respectively; death-censored kidney graft survival was 85%. One year pt and kidney graft survival rates were 93.5% and 89%, respectively. Death with a functioning graft accounted for 5 of the 11 graft losses. At present, 36 of the 39 surviving pts (92%) have functioning grafts. Causes of death in 7 pts were cardiovascular (3), sepsis (3), and malignancy (1). The incidences of surgical complications, acute rejection and major infection were 9%, 20%, and 24%, respectively. In 13 cases, the mate kidney from the same donor was transplanted into a <70 year old pt (mean age 58 years). Pt (92%) and kidney graft survival (77%) rates in the donor-matched pairs were identical in the older and younger age cohorts. Conclusion: Excellent medium-term outcomes can be achieved in appropriately selected elderly pts using predominantly ECD kidneys.

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