Kidney transplantation outcomes in the elderly have been favorable but detailed accounts of these outcomes from non-registry data is limited.
The purpose of this study was to compare patient and graft survival, as well as risk factors for these outcomes, in a younger and older subset of elderly transplant patients.
Two cohorts, ages 50 to 64 (n=2656) and 65 or older (n=382) at time of transplant, were compared using chi-square test or two sample t-test, and regression analysis.
3038 patients were studied with a mean follow-up of 10.2 +/- 8.3 years (range: 0-47.9 years). There was no difference in risk of graft failure between the two cohorts (Figure 1). In patients with graft failure, time to failure was shorter in the older cohort (1682 vs. 2700 days, P=0.02). Of course, there was a higher risk of death in the older cohort [(HR 2.97 (95% CI 2.52-3.50, P<0.01)].
Risk factors for graft failure in younger recipients were smoking, black or other race, PRA > 10%, and CHF. In the older cohort only PRA > 10% was predictive. Living related donor and any cancer in the younger cohort but no factors in older cohort appeared to decrease risk of graft failure.
Risk factors for death in younger cohort were smoking, deceased donor, failed graft, CAD, CHF, non-skin cancer, and HTN as cause of ESKD. In older cohort risk factors for death were failed graft and CHF. Factors that decreased risk of death were Asian race, PVD, skin cancer, and glomerulonephritis as cause of ESKD, in the younger cohort and skin cancer in older cohort.
There was no significant difference in the risk of graft failure between the younger and older cohorts. Many risk factors associated with graft failure or death in the younger cohort were not observed in the older cohort.
To cite this abstract in AMA style:Faravardeh A, Bista B, Eickhoff M, Jackson S, Spong R, Matas A, Ibrahim H. Risk Factors for Graft Failure and Death in Elderly (>65 Years Old) Kidney Transplant Recipients [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/risk-factors-for-graft-failure-and-death-in-elderly-65-years-old-kidney-transplant-recipients/. Accessed December 6, 2023.
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