Abstract

Introduction: As the number of elderly patients with end-stage kidney disease (ESKD) increases, the importance of understanding how age affects post-transplant success grows. We sought to quantify the association of age with key outcomes in deceased donor kidney transplant (DDKT) recipients.
Materials and methods: We did a single-center retrospective cohort analysis of all DDKT recipients who received kidneys between January 2001 and June 2021, stratified by age into 4 groups (18 – 49, 50 – 59, 60 – 69, ≥ 70). Outcomes of interest included uncensored graft failure (UCGF), death-censored graft failure (DCGF), and death with a functioning graft (DWFG) within 5 years of transplant and acute rejection (AR) within 1 year of transplant.
Results: Of 3,119 recipients, 1,192 (38.2%) were 18 – 49 years old (reference group), 947 (30.4%) were 50 – 59, 795 (25.5%) were 60 – 69, and 185 (5.9%) were ≥ 70. The adjusted hazard ratio (aHR) for UCGF was 1.22 (95% CI: 1.01 – 1.48) for 50 – 59 years; 1.78 (95% CI: 1.47 – 2.17) for 60 – 69; and 2.83 (95% CI: 2.13 – 3.76) for ≥ 70. The aHR for DCGF was only statistically significant for the ≥ 70 age group at 1.73 (95% CI: 1.16 – 2.96). The aHR for DWFG was 2.00 (95% CI: 1.47 – 2.73) for 50 – 59 years; 3.36 (95% CI: 2.47 – 4.58) for 60 – 69; and 5.45 (95% CI: 3.95 – 8.26) for ≥ 70. The aHR for AR was 0.73 (95% CI: 0.61 – 0.88) for 50 – 59 years; 0.69 (95% CI: 0.56 – 0.84) for 60 – 69; and 0.47 (95% CI: 0.31 – 0.72) for ≥ 70.
Conclusion: DDKT recipients over the age of 70 are at a higher risk of UCGF, DCGF, and DWFG but have a lower risk of AR than their younger counterparts.

Author Details

Authors

• Paul E. Schindler¹
• Dave B. Patel¹
• Camille R. Ylagan¹
• Adam P. Bregman¹
• Didier Mandelbrot¹
• Brad C. Astor^{1, 2}
• Sandesh Parajuli¹

Departments

• ¹ Division of Nephrology, Department of Medicine, and
• ² Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

Address

Sandesh Parajuli, MD
4175 MFCB, 1685 Highland Ave
Madison, WI 53705, USA
Email: [email protected]

Citation