Infectious Complications in Kidney Transplant Recipients Age 65 and Older

L. E. Liriano-Ward¹, M. Barbachan e Silva², Y. Azzi¹, M. Ajaimy¹, A. Cambell¹, J. Graham¹, J. Rocca¹, C. Pynadath¹, G. Nair¹, O. Andacoglu¹, S. Greenstein¹, P. Ó Broin², E. Akalin¹

¹Transplant, Einstein/Montefiore Medical Center, Bronx, NY, ²School of Mathematics, Statistics & Applied Mathematics, National University of Ireland Galway, Galway, Ireland

Meeting: 2019 American Transplant Congress

Abstract number: A351

Keywords: Age factors, Elderly patients, Infection

Session Information

Session Name: Poster Session A: Transplant Infectious Diseases

Session Type: Poster Session

Date: Saturday, June 1, 2019

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall C & D

*Purpose: Kidney transplant recipients age 65 years and older are at higher risk for development of infections. We aimed to investigate the incidence of both opportunistic and non-opportunistic infections and malignancy in those patients, and its association with type of induction treatment.

*Methods: We reviewed all patients over the age of 65 transplanted at our center from January 2013 to June 2017.

*Results: 149 patients were included in the study with a median age of 68 years (66-79); 62% were male, 42% African American, and 93% received a deceased donor kidney transplant. 50% of the patients received basiliximab, 37% anti-thymocyte globulin, and 13% antithymocyte globulin and intravenous immunoglobulin induction treatment. One year patient and graft survival was 97% and 94% respectively. During a median follow up of 38.4 months (0.3, 71), patient and graft survival was 85% and 90% respectively. The overall incidence of acute rejection was 5% and 1% for chronic rejection. The overall incidence of opportunistic infections and malignancy was high and observed in 60 patients (40%) (BK viremia 21%, CMV viremia 11%, fungal infections 9% and malignancy 11%), and non-opportunistic infections were observed in 57% of the patients (UTI 42%, bacteremia 16%, pneumonia 9%, c. diff 7%, cellulitis/osteomyelitis 5%); 39% of all infections occurred within the first year. There was no statistical significant difference in terms of age, sex, race, time on dialysis, and type of induction treatment (53% vs. 47% anti-thymocyte globulin use) in patients who developed opportunistic infections and malignancy. There were more acute rejection episodes (11.7% vs. 1.1%) observed in patients with opportunistic infections and malignancy but the difference was not statistically significant. The infections and malignancy did not impact patient and graft survival.

*Conclusions: Although, the incidence of opportunistic and non-opportunistic infections and malignancy is high in kidney transplant recipients over age of 65, it did not impact the short term patient and graft survival. Use of anti-thymocyte globulin does not increase the risk of infections and malignancy.

To cite this abstract in AMA style:

Liriano-Ward LE, Silva MBarbachane, Azzi Y, Ajaimy M, Cambell A, Graham J, Rocca J, Pynadath C, Nair G, Andacoglu O, Greenstein S, Broin PÓ, Akalin E. Infectious Complications in Kidney Transplant Recipients Age 65 and Older [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/infectious-complications-in-kidney-transplant-recipients-age-65-and-older/. Accessed May 13, 2025.

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