Abstract
BackgroundElderly patients with end-stage renal disease have become the fastest growing population of kidney transplant candidates in recent years. However, the risk factors associated with long-term outcomes in these patients remain unclear.MethodsWe retrospectively analyzed 166 recipients aged 60 years or older who underwent primary deceased kidney transplantation between 2002 and 2013 in our center. The main outcomes included 1-, 3- and 5-year patient survival as well as overall and death-censored graft survival. The independent risk factors affecting graft and patient survival were analyzed using Cox regression analysis.ResultsThe 1-, 3-, 5-year death-censored graft survival rates were 93.6%, 89.4% and 83.6%, respectively. Based on the Cox multivariate analysis, panel reactive antibody (PRA)>5% [hazard ratio (HR) 4.295, 95% confidence interval (CI) 1.321–13.97], delayed graft function (HR 4.744, 95% CI 1.611–13.973) and acute rejection (HR 4.971, 95% CI 1.516–16.301) were independent risk factors for graft failure. The 1-, 3-, 5-year patient survival rates were 84.8%, 82.1% and 77.1%, respectively. Longer dialysis time (HR 1.011 for 1-month increase, 95% CI 1.002–1.020), graft loss (HR 3.501, 95% CI 1.559–7.865) and low-dose ganciclovir prophylaxis (1.5 g/d for 3 months) (HR 3.173, 95% CI 1.063–9.473) were risk factors associated with patient death.ConclusionsThe five-year results show an excellent graft and patient survival in elderly kidney transplant recipients aged ≥60 years. PRA>5%, delayed graft function, and acute rejection are risk factors for graft failure, while longer duration of dialysis, graft loss and low-dose ganciclovir prophylaxis are risk factors for mortality in elderly recipients. These factors represent potential targets for interventions aimed at improving graft and patient survival in elderly recipients.
Highlights
Kidney transplantation is considered to be the best treatment option for patients with end-stage renal disease (ESRD), regardless of their age
Based on the Cox multivariate models, a panel reactive antibody (PRA).5% [hazard ratio (HR) 4.295, 95% confidence interval (CI) 1.321–13.97], delayed graft function (DGF) (HR 4.744, 95% CI 1.611–13.973) and acute rejection (AR) (HR 4.971, 95% CI 1.516–16.301) remained independent risk factors for deathcensored graft loss, except for longer dialysis time (Table 4)
When data was analysis by final Cox multivariate model, we found that longer dialysis time (HR 1.011 for 1-month increase, 95% CI 1.002–1.020), graft loss (HR 3.501, 95% CI 1.559–7.865) and low-dose ganciclovir prophylaxis
Summary
Kidney transplantation is considered to be the best treatment option for patients with end-stage renal disease (ESRD), regardless of their age. The mean age of patients undergoing renal transplantation has increased. This trend is observed in western countries such as America and in Asian countries. Patients $60 years with ESRD have become the fastest growing population of wait-listed individuals and kidney transplant candidates [1,2]. Previous studies have reported that elderly ESRD patients after kidney transplantation have lower mortality rates and improved quality of life compared with those who remain on dialysis treatment [3,4,5]. Patients with end-stage renal disease have become the fastest growing population of kidney transplant candidates in recent years. The risk factors associated with long-term outcomes in these patients remain unclear
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
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 call
