Comparing Outcomes of Kidney Transplantation in Octogenarians to Septuagenarians
Transplantation Surgery, Fletcher Allen Health Care, Burlington, VT
College of Medicine, University of Vermont, Burlington, VT
Meeting: 2013 American Transplant Congress
Abstract number: A814
Background: With an increasing life expectancy, more patients in their late 70s and early 80s are presenting for evaluation for kidney transplantation. We examined the outcomes of kidney transplantation in a small rural center with patients between the ages of 70 to 85.
Study Design: We performed a retrospective chart review of outcomes in patients aged 70 -74 (26 patients), 75-79 (10 patients) and 80-84 (8 patients) who underwent a kidney transplant at this institution between January 1, 2003 and December 31, 2011. We collected data on patient demographics, donor demographics, patient and graft outcomes. Immunosuppression was basiliximab induction with tacrolimus, mycophenolate maintenance.
Results: We have up to 9 years of follow up on 44 patients. There were no significant differences in patient demographics need for chronic dialysis, median duration of dialysis, diabetes, hypertension and cardiac co-morbidities. There were no significant differences in patient or graft survival between the 3 groups.
| 70-74 n=26 | 75-79 n=10 | 80-84 n=8 | p Value | |
|---|---|---|---|---|
| Median time on waitlist, days | 520 | 162 | 325 | >0.5 |
| ECD donor | 42.3% | 70.0% | 75% | >0.5 |
| Living Donor | 19% | 11% | 0% | >0.5 |
| DGF | 31% | 0% | 38% | >0.5 |
| Median post transplant LOS, days | 7 | 9 | 7 | >0.5 |
| Inpatient readmission to 1 year | 65% | 80% | 75% | >0.5 |
| Mean 12 month eGFR (SD) | 43 (15) | 48 (12) | 40 (20) | >0.5 |
| Mean 12 month serum creatinine mg/ml (SD) | 2.0 (1.2) | 1.4 (0.5) | 1.9 (1.2) | >0.5 |
| Graft Survival | 85% | 100% | 88% | >0.5 |
| Patient Survival | 65% | 90% | 75% | >0.5 |
There were no significant differences in rates of complications or lengths of stay.
| 70-74 n=26 | 75-79 n=10 | 80-84 n=8 | |
|---|---|---|---|
| Post-Operative | |||
| C difficile | 12 % | 0 % | 0 % |
| UTI | 4 % | 10% | 0 % |
| Wound infection | 4 % | 0% | 0 % |
| Respiratory | 12 % | 0 % | 0 % |
| Cardiac | 12 % | 20 % | 25 % |
| Long Term | |||
| BK Viruria | 4 % | 20 % | 0 % |
| BK Viremia | 8 % | 0 % | 0 % |
| BK Nephropathy | 8 % | 0 % | 0 % |
| CMV infection | 4 % | 0 % | 0 % |
| Neoplasm Skin | 23 % | 20% | 13 % |
| Neoplasm other | 12 % | 33% | 0 % |
| Cellular Rejection | 23 % | 0 % | 0 % |
| Humoral rejection | 4 % | 0 % | 0 % |
Conclusion: With appropriate screening and selection, kidney transplantation can be performed successfully in octogenarians.
To cite this abstract in AMA style:
Paine A, Moon D, Sigounas V, Taylor M, Yamaguchi J, Carlo ADi. Comparing Outcomes of Kidney Transplantation in Octogenarians to Septuagenarians [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/comparing-outcomes-of-kidney-transplantation-in-octogenarians-to-septuagenarians/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress