Excellent Outcomes With Kidney Transplantation for Patients ≥70 Years of Age
1Transplant Surgery, Mayo Clinic Arizona, Phoenix, AZ
2Nephrology, Mayo Clinic Arizona, Phoenix, AZ.
Meeting: 2015 American Transplant Congress
Abstract number: B222
Keywords: Age factors, Elderly patients, Outcome, Survival
Session Information
Session Name: Poster Session B: Obesity/Elderly/Frail
Session Type: Poster Session
Date: Sunday, May 3, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Background
Our aim was to determine the outcomes following kidney transplantation in recipients ≥70 years of age at the time of transplantation.
Materials and Methods
We analyzed data on all patients who received a kidney transplant at our center between July 2001 and June 2014. We identified 188 patients who were who were ≥70 years of age at the time of transplant. The control group included 1637 recipients who were <70.
Results
The median age for the older cohort was 72 (IQR 71-75, range 70-85). The older cohort was more likely to be male, diabetic, receive a deceased donor (DD) kidney (63% vs. 47%, p<.0001) and an ECD kidney (45% vs. 18% of DD, p<.0001). For the older cohort, prior to transplant 32% had history of coronary artery disease, 22% had history of coronary revascularization and 6% had peripheral vascular disease.
Length of hospital stay (LOS), rate of delayed graft function (DGF) and rejection rate during the first year were not different. The eGFR (CDK-EPI) at 1 year was lower in the older cohort. 23% of the older group was readmitted within 30 days of transplant.
Graft survival was not different in the older cohort, but the death rate was higher. Death with functioning graft was the most common cause of graft loss in the older cohort (69.4% vs. 40.5%, p<.0001).
For the older cohort, readmission within 30 days was the only baseline factor that correlated with a higher risk of subsequent death (RR 2.83, 95% CI 1.16-6.29, p=0.02).
| Age <70 | Age≥70 | P Value | |
| DGF (DD only) | 36% | 37% | 0.88 |
| LOS (median, IQR) | 3 (3-4) | 4 (3-4) | 0.15 |
| Rejection 1st yr | 15% | 15% | 0.94 |
| BK | 14% | 20% | 0.13 |
| CMV | 8.4% | 3.7% | 0.013 |
| Cr 1 month | 1.64±0.88 | 1.62±0.80 | 0.86 |
| Cr 1 yr | 1.41±0.93 (n=1198) | 1.31±0.66 (n=142) | 0.21 |
| eGFR 1 yr | 60.5±20.4 | 55.8±17.5 | 0.0085 |
| eGFR<30 at 1 yr | 4.9% | 5.4% | 0.78 |
| Age <70 (%) | # at risk | Age ≥70 (%) | # at risk | P (log rank) | |
| Number | 1637 | 188 | |||
| 1 yr graft | 96.3 | 1468 | 95.7 | 170 | |
| 3 yr graft | 90.5 | 982 | 84.9 | 95 | |
| 5 yr graft | 83.4 | 500 | 79.0 | 52 | 0.07 |
| 1 yr patient | 97.9 | 1468 | 97.2 | 169 | |
| 3 yr patient | 94.4 | 983 | 89.2 | 95 | |
| 5 yr patient | 90.0 | 495 | 83.1 | 52 | 0.001 |
Conclusions
Graft survival at 1, 3 and 5 yrs was similar for recipients ≥70 compared to those <70. Death with functioning graft accounted for 69% of the graft losses in the ≥70 cohort compared to 40% in the <70 cohort. Both live and deceased donor kidney transplantation are excellent treatment options for carefully selected older patients with ESRD.
To cite this abstract in AMA style:
Haakinson D, Reddy K, Moss A, Katariya N, Singer A, Mathur A, Huskey J, Khamash H, Heilman R. Excellent Outcomes With Kidney Transplantation for Patients ≥70 Years of Age [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/excellent-outcomes-with-kidney-transplantation-for-patients-70-years-of-age/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress