Survival Comparison of Waitlisted and Renal Transplanted Patients in the European Senior Programme

M. G. Naik¹, V. Greese¹, K. U. Eckardt¹, U. Frei¹, P. Glander¹, L. Liefeldt¹, M. Pigorsch², E. Schaeffner³, K. Budde¹, F. Halleck¹

¹Medical Department, Division of Nephrology and Internal Intensive Care Medicine, Charité, Berlin, Germany, ²Institute of Biometry and Clinical Epidemiology, Charité, Berlin, Germany, ³Institute of Public Health, Charité, Berlin, Germany

Meeting: 2022 American Transplant Congress

Abstract number: 391

Keywords: Elderly patients, Kidney transplantation, Survival, Waiting lists

Topic: Clinical Science » Kidney » 32 - Kidney Deceased Donor Selection

Session Information

Session Name: Kidney Deceased Donor Selection II

Session Type: Rapid Fire Oral Abstract

Date: Tuesday, June 7, 2022

Session Time: 3:30pm-5:00pm

Presentation Time: 3:30pm-3:40pm

Location: Hynes Ballroom C

*Purpose: Patients >65years are eligible for kidney transplantation (KT) in the European Senior Program (ESP). We compare patient survival of waitlisted (WTL) and transplanted (Tx) patients in the ESP over 20years.

*Methods: All WTL patients in the ESP at Charité Berlin from 1999 to 2019 were included into this analysis. The first transplantable status on the active waitlist at/after 65^th birthday marked the baseline. To investigate patient survival, landmark (LM) analyses were performed at 6-, 12-, 18- and 24-months after baseline. At each LM, patients were assigned to WTL or Tx depending on their status at each LM. Survival was estimated using Kaplan Meier analysis. Patients with transplantable status before the age of 65 and thus having participated in the regular allocation program before entering ESP were excluded from further age-dependent survival analyses.

*Results: 783 patients (39% female, median+IQR 64 (61-68)years at dialysis initiation, 66 (64-70)years at listing, 324 WTL, 459 Tx) with complete follow-up in 776 (99.1%) were included. Overall, 10-year patient survival was similar in Tx vs WTL patients not receiving a KT: 37.9 vs 37.8% (p=0.85) at 6-, 32.2 vs 32.7% (p=0.89) at 12-, 29.5 vs 36.5% (p=0.52) at 18- and 32 vs 33.4% (p=0.98) at 24months, respectively. 260 patients (33.2%) were listed before the age of 65. At LM6 and 12 younger (65-69) Tx showed no survival difference compared to WTL patients, but older Tx patients >69years showed lower survival compared to WTL patients.

LM18 and 24 are shown in table1.

LM18 and 24months, group, no at risk, 10-year survival rate, p
18months	WTL65-69	15	35.6	0.87
	Tx 65-69	10	30.4
	WTL >69	4	33.3	0.187
	TK>69	4	19.3
24months	WTL 65-69	11	35.5	0.55
	Tx 65-69	14	36.1
	WTL >69	2	32	0.17
	TX>69	2	18.3

*Conclusions: Patients >65years at time of waitlisting and transplanted in ESP had no survival benefit compared to patients, who remained on the waitlist. Importantly, Tx patients >69years had lower patient survival after transplantation compared to patients, who remained on dialysis. Our results demonstrate that thorough risk-benefit assessment is needed for elderly patients waitlisted for transplantation. Further survival analyses need to be adjusted.

To cite this abstract in AMA style:

Naik MG, Greese V, Eckardt KU, Frei U, Glander P, Liefeldt L, Pigorsch M, Schaeffner E, Budde K, Halleck F. Survival Comparison of Waitlisted and Renal Transplanted Patients in the European Senior Programme [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/survival-comparison-of-waitlisted-and-renal-transplanted-patients-in-the-european-senior-programme/. Accessed December 3, 2024.

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