Immunologic Outcomes in Elderly Kidney Transplant Recipients
Nephrology, Charité
Universitätsmedizin Berlin, Berlin, Germany.
Meeting: 2015 American Transplant Congress
Abstract number: 445
Keywords: Elderly patients, Kidney transplantation, Outcome
Session Information
Session Name: Concurrent Session: Kidney - Delayed Graft Function and Older Age
Session Type: Concurrent Session
Date: Tuesday, May 5, 2015
Session Time: 4:00pm-5:30pm
Presentation Time: 5:00pm-5:12pm
Location: Room 115-AB
BACKGROUND: Only few data are available about immunologic outcomes of elderly kidney transplant recipients (KTR).
PATIENTS AND METHODS: This retrospective long-term observational study included all adult kidney transplant recipients at our center 2006-2014 (n=814). Follow-up DSA analysis was routinely performed. Allograft biopsies were performed for clinically suspected rejections. Categorization of age at transplantation was < 65 versus ≥ 65 years (n=609, 74.9% vs. n=205, 25.1%, respectively). Outcome data were assessed over a period of maximal 8 years.
RESULTS: Patient characteristics are shown in Table1. 7-year patient and graft survival were significantly different between the two groups (Fig.1A-C). While elderly KTR tended to have a higher frequency of DSA (Fig.1D) the incidence of ABMR was not significantly different (Fig.1E). The risk of TCMR was significantly higher in the elderly group (Fig.1F). The multivariate analysis adjusted for donor and recipient age, mismatches, sex and prior transplantation identified mismatches as the only independent risk factor for TCMR (HR 1.201, p<0.001).
CONCLUSION: Due to the nature of the Eurotransplant senior program increased age of donors and recipients and more HLA mismatches are risk factors for worse graft outcomes and mortality. While the incidence of TCMR was higher, ABMR was not increased in elderly KTRs despite a trend of more de novo DSA.
| Patient characteristics | all; n=814 | recipient age <65 years; n=609 | recipient age ≥ 65 years; n=205 | p |
| Mean follow up, years (SD) | 3.8 (2.4) | 3.9 (2.4) | 3.6 (2.3) | 0.105 |
| Mean recipient age, years (SD) | 52 (15) | 46 (12) | 69 (4) | <0.001 |
| Mean donor age, years (SD) | 54 (15) | 49 (12) | 69 (9) | <0.001 |
| Male, n | 489 (60%) | 370 (61%) | 119 (58%) | 0.510 |
| Living donor, n | 259 (32%) | 238 (39%) | 21 (10%) | <0.001 |
| Prior kidney transplantation, n | 93 (11%) | 84 (14%) | 8 (4%) | <0.001 |
| Median time on dialysis, months (IQR) | 55 (24-86) | 63 (23-92) | 44 (25-62) | <0.001 |
| Median cold ischemia time, hours (IQR) † | 11.2 (8.0-14.6) | 11.8 (8.4-15.5) | 9.9 (7.6-12.3) | <0.001 |
| Median HLA-mismatches (IQR) | 3 (2-4) | 2 (2-3) | 4 (3-5) | <0.001 |
| † in patients with deceased donors (n=555) |
To cite this abstract in AMA style:
Khadzhynov D, Halleck F, Liefeldt L, Glander P, Bamoulid J, Kreimer S, Lehner L, Budde K, Staeck O. Immunologic Outcomes in Elderly Kidney Transplant Recipients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/immunologic-outcomes-in-elderly-kidney-transplant-recipients/. Accessed October 30, 2024.« Back to 2015 American Transplant Congress