Abstract
Objective To analyze the characteristics and prognosis of elderly renal transplant recipients. Methods The authors included 130 recipients older than or equal to 60 years at the time of operation in elderly group, and the paired 130 patients receiving contralateral renal transplants from the same donors and younger than 60 years in control group. All the patients received renal transplant in Kidney Disease Center of the First Affiliated Hospital of Zhejiang University from Nov 1994 to Dec 2013. Results The average age of the patients of elderly group was (63±3) years old, whereas the patients in control group were (41±10) years old. There was no significant difference in sex, type of dialysis, number of mismatched HLA, level of panel reactive antibodies (PRA), percentage of receiving induction therapy or immunosuppressive regimen between elderly group and control group, except that the patients in old group had a longer duration of dialysis. The patients of elderly group had a lower level of serum creatinine than control at the follow up times from 6 months to 24 months after transplant. The doses of immunosuppressives were lower in elderly group compared with the control group whereas the concentration of tacrolimus or cyclosporine was same. The dose of prednisone in old group was lower compared with control after 6 months post-transplantation. The patients of elderly group had high percentages of pulmonary infection and new-onset diabetes mellitus compared with the control group. Until June 2014, the follow-up rate of all patients was 85.4%; the median follow-up time was 70.4 months in elderly group and 79.9 months in control group. There was no significant difference in mortality rate or graft loss rate between elderly group and control group. Pulmonary infection (HR=2.981, P=0.018), hepatitis C virus infection (HR=5.797, P=0.003) and malignancies (HR=5.228, P=0.005) were correlated with the survival rate of the elderly group. Conclusions Elderly renal transplant recipients have a similar prognosis compared with the younger ones. Pulmonary infection, hepatitis C virus infection and malignancy are related risk factors for the survival rate of elderly patients. Key words: Elderly; Renal transplantation; Prognosis
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