SUN-318 Study of elderly Renal Transplant recipient patients in Vidarbha region in Central India

Abstract

Renal transplantation is accepted mode of renal replacement therapy all over the world. This is the best mode of rehabilitation as compared to hemodialysis or continuous ambulatory peritoneal dialysis. However in spite of a large number of CKD in elderly age group, number of transplants done for them is less. This study was carried out to know the problems faced for this group of patients. All kidney transplants done since 1990 till July 2019 done in Vidarbha region were studied. Data from all transplant physicians of this region were included. Patients below 60 years age and kidney transplants performed in hospitals out of this region were excluded. Demographic parameters like age, sex, donor profile, complications, outcome were studied. In all there were 714 patients who underwent kidney transplantation in Vidarbha region. Out of these live donor Transplants were 622 and deceased donor transplants were 92. Number of patients transplanted at age of 60 & more were 25 ie. only 3.5% of all the transplants. Infective Complications were very common. Bacterial sepsis was seen in 9 patients, 3 due to urosepsis, 2 pneumonias, 1 each fournier’s gangrene, pulmonary and cerebellar nocardia, skull based osteomyelitis and Cytomegalovirus infection. Fungal sepsis was noted in one patient. Out of 14 deaths, 11 were due to infective causes. 9 succumbed mostly due to infective episodes( 65%). 6 patients died within 1 month post transplant and 2 within 6 months. All were cadaver transplants. Non infective complications seen were acute myocardial infarction, acute pulmonary embolism and antibody mediated rejections. Kidney transplantation in elderly CKD patients is challenging. At elderly age, live transplants are less frequent but more rewarding while deceased donor transplants carry higher rate of complications. They face cardiac, pulmonary and infective complications more frequently. A properly selected elderly patient must be given a choice of kidney transplant but they need to be observed more diligently for cardiac, pulmonary and infective complications.