Survival Comparison of Waitlisted and Renal Transplanted Patients in the European Senior Programme
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 65th 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.
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 November 9, 2024.« Back to 2022 American Transplant Congress