Does Insurance Type Influence Risk Assessment in Elderly Kidney Candidates?

Abstract

Introduction:Outcomes of elderly kidney recipients is of great interest. We analyzed OPTN database to assess unique outcome predictors. Methods:We evaluated first kidney recipients in OPTN database from 1987 to 2010 who received non-DCD, Standard Criteria Donor grafts only. Results:Two variables had significant interaction with age at transplant: donor type (living v. deceased) & insurance type at transplant (private (PI) v. gov (GI)) creating 4 unique recipient groups: living donor-govt (LD-G), living donor-private (LD-P), deceased donor-govt (DD-G), & deceased donor-private (DD-P). LD-P recipients had lowest risk of death & DDG the highest. In age over 60, differences in survival increase benefiting DD-P. Overall graft survival for those under 60 paralleled the above with LD-P the best & DD-G the worst. The LD-G and DD-P groups were similar until age 60 when the DD-P group had worsening graft survival. LD-G approached the best performing LD-P. Conclusion:Higher risk older patients with PI are more likely to undergo LD or DD kidney transplant than those with GI.Table: No Caption available.Figure: No Caption available.Figure: No Caption available.