Background: There is a significant increase in the number of older renal transplant recipients in the United States. Physical function (PF) may impact mortality in addition to age alone in this high risk group. We assessed the association between physical function (PF) and patient survival in renal transplant recipients who are 65 years of age or older.

Methods: Using the UNOS/OPTN data base, 26,086 primary renal transplant recipients 65 years of age or older with known functional status at time of transplant from 2001 to 2016 were included (DD 19,101, LD 6985). Univariate and multivariable methods were used to assess associations between survival and functional status adjusted for age, gender, race, donor quality, diabetes and dialysis vintage. Separate analysis was done for deceased donors (DD) and living donor (LD) renal transplants.

Results: Patient survival and functional status at transplantation was significantly better in LD compared to DD recipients (38% vs 32% no assistance). In DD transplants 3-year patient survival was 85% for patients with needing no assistance, 82% for moderate assistance and 73% for total assistance (p<0.0001). In contrast in LD KTA patient survival was 92% at 3-year post-transplant for patients needing no assistance, 89% moderate assistance and 88% total assistance. In the multivariate model adjusted for additional risk factors, the relative risk for mortality was 1.94 (1.64-2.31) for total assistance, 1.17 (1.07-1.27) for moderate assistance compared to needing no assistance for DD transplants, and in LD transplants 1.45, (95% CI 0.82-2.55) for patients with total assistance, 1.38 (1.15 -1.66) with moderate assistance in comparison with patience without needing assistance.

Conclusion: While physical function is a clear independent risk factor in DD kidney transplants, the impact was not as clear in LD transplants. This may be due to a very careful selection of patients and their potential donors. Nevertheless, physical function is an independent predictor of post transplantation mortality. Assessment of older potential renal transplant recipients should include assessment of functional status to counsel about post-transplant complications.

CITATION INFORMATION: Brar A., Tedla F., Salifu M., Gruessner R., John D., Sumrani N., Gruessner A. Association of Physical Function and Survival in Elderly Renal Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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