Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Study Purpose: Our aim was to investigate if among older KT recipient, the types of infections, number of rejections, graft and patient survival in the first year after KT differ when compared to younger adults.
Methods: Retrospective case control study of all KT performed at our center on older adults aged ≥65 years in a 5-year period (2011-2015). These cases were matched 1:1 to controls, aged 40-60, to sex, and, if possible to race and year of KT. Demographic, clinical and outcome data were collected. Descriptive analyses and proportional hazard modeling were used.
Results: 91 kidney-only transplants had been performed on older adults. Most were male (60%) and Caucasian (62%). Some characteristics are shown in:
|Basiliximab induction %||48||50|
|Recipient CMV+ %||69||59|
|Delayed graft function %||26||16|
|Donor age, mean (yr)||44||39|
|Deceased donation %||73||66|
|Donor CMV+ %||69||64|
92% of the cases developed an infection and 90% of the controls. No significant difference between number of infections between cases and controls was found, 3.1 (95%CI 2.6,3.6) vs 2.6 (95%CI 2.1,3.0), respectively. Infections are summarized in:
|Infectious episodes, n||65+||40-60||p|
Each additional infection episode increased the HR of another infection by 10% in the cases. However, there is no impact of age on this measure. 7 cases each experienced 1 rejection vs 12 controls (16 episodes), p=0.22. 3 cases and 2 controls lost their graft. Patient survival differed, with 9.9% of deaths in the cases and 1.1% in the controls (p=0.02).
Conclusions: Despite the high frequency of infectious complications, the majority of KT recipients are alive and have a functioning graft one-year after KT. While the overall number of infectious complications between older and younger adults did not differ, urinary tract infections were significantly more frequent in older adults. A better understanding of immunosuppressive regimens and antimicrobial prophylaxis might be able to mitigate infectious complications.
CITATION INFORMATION: Hemmersbach-Miller M., Schmader K. Early Infectious Outcomes of Older Adults Undergoing Kidney Transplantation (KT). A Case Control Study Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Hemmersbach-Miller M, Schmader K. Early Infectious Outcomes of Older Adults Undergoing Kidney Transplantation (KT). A Case Control Study [abstract]. https://atcmeetingabstracts.com/abstract/early-infectious-outcomes-of-older-adults-undergoing-kidney-transplantation-kt-a-case-control-study/. Accessed December 7, 2019.
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