Abstract
To evaluate the outcomes of kidney transplantations (KTs) in the Eurotransplant Senior Program (ESP) with a focus on the very old, defined as recipients ≥75 years. This retrospective clinical study included 85 patients, who under the ESP protocol underwent deceased donor kidney transplantation from January 2010 to July 2018 at the Charité–Universitätsmedizin Berlin in Germany. Recipients were divided in three age groups, i.e., Group 65–69, Group 70–74, Group ≥75, and compared. Prognostic risk factors for short and long-term outcomes of kidney transplantations were investigated. Graft survival at 1 and 5 years were respectively 90.7% and 68.0% for group 65–69, 88.9% and 76.2% for Group 70–74, and 100% and 71.4% for Group ≥75. Patient survival at 1 and 5 years were respectively 92.9% and 68.0% for Group 65–69, 85.7% and 61.5% for Group 70–74 and 100% and 62.5% for Group ≥75. Serum creatinine did not significantly differ between the three groups, with the exception of serum creatinine at 1 year. Increased recipient age and prolonged time on dialysis correlated with increased occurrence of postoperative complication. An increase in BMI, pretransplant diabetes mellitus and prolonged time on dialysis correlated with the occurrence of delayed graft function (DGF). History of smoking was identified as an independent risk factor for events of rejection. Increased human leukocyte antigen mismatches (HLA-MM) and prolonged cold ischemia time (CIT) correlated with higher rates of intensive care unit (ICU) treatment. This study supports kidney transplantations for the very old. End-stage renal disease (ESRD) patients ≥75 years of age who underwent kidney transplantation experienced comparable results to their younger counterparts. A comprehensive evaluation of ESRD patients with consideration of prognostic risk factor is the most suitable mean of identifying adequate kidney transplant candidates.
Highlights
Kidney transplantation is considered the treatment of choice in End-stage renal disease (ESRD), increasing life expectancy and quality of life even for recipients aged ≥65 years [1–4]
Recipients were divided into three groups with respect to their age at the time of kidney transplantations (KTs) in years as following: Group 65–69, Group 70–74, and Group ≥75
The immunosuppression protocol after KT was identical for all patients and consisted of tacrolimus, mycophenolate mofetil (MMF) and prednisolone
Summary
Kidney transplantation is considered the treatment of choice in ESRD, increasing life expectancy and quality of life even for recipients aged ≥65 years [1–4]. The shortage of renal allograft donors combined with an increased demand from an ever-ageing population has led to the use of expanded criteria donor (ECD) kidneys. ECD kidneys, despite being of lower quality than standard criteria donor (SCD) kidneys, minimize waitlisted time for recipients while providing a survival advantage compared wait-listed dialysis patients [3–6]. Good results have been reported in recipients aged ≥65 years, only few studies have focused on the potential benefits of kidney transplantations (KTs) in the very old [3–9]. Studies that evaluated renal allograft recipients over 70 years compared to a waitlisted group or younger counterparts revealed that ≥70-year recipients benefited from the procedure [10–12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
