TY - JOUR
T1 - Clinical outcomes in Asian elderly kidney transplant recipients
T2 - A multicenter cohort study
AU - Yoo, K. D.
AU - An, J. N.
AU - Kim, C. T.
AU - Cho, J. H.
AU - Kim, C. D.
AU - Park, S. K.
AU - Chae, D. W.
AU - Oh, Y. K.
AU - Lim, C. S.
AU - Kim, Y. S.
AU - Kim, Y. H.
AU - Lee, J. P.
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/4/1
Y1 - 2015/4/1
N2 - Background The kidney transplantation rate in elderly patients is increasing rapidly. However, the clinical outcomes of kidney transplantation in elderly patients have not yet been thoroughly evaluated. Methods This multicenter cohort study included adult kidney transplant recipients (KTRs) admitted to five major tertiary hospitals in Korea between 1997 and 2012. A total of 3,565 adult participants were enrolled. Patient survival, allograft survival, and biopsy-proven acute rejection (BPAR) of 242 elderly recipients (≥60 years) were assessed and compared with those of a younger population. Results Patients were divided into five groups according to age at time of transplantation. The proportion of elderly patients was 6.7 % (mean age, 63.1 ± 2.7 years; n = 242). The numbers of male patients (69.4%), those with diabetes mellitus history (36.3%), and those with pretransplantation ischemic heart disease history (17.7%) were significantly higher in the elderly group than in the younger age groups. Elderly patients were more likely to receive a cadaveric kidney, and overall mortality rates were significantly higher in the elderly patients (1-year survival 93.3%, 5-year survival 91.3%). However, death-censored allograft survival rate and BPAR were not affected by patient age (P =.104 and.501, respectively). Among the elderly, BPAR and female donors were independent risk factors for allograft loss. Conclusion The overall survival rate of the elderly KTRs was significantly lower than that of younger KTRs. However, the death-censored allograft survival rate did not differ between groups. Kidney transplantation should not be stagnated especially in elderly patients with end-stage renal disease.
AB - Background The kidney transplantation rate in elderly patients is increasing rapidly. However, the clinical outcomes of kidney transplantation in elderly patients have not yet been thoroughly evaluated. Methods This multicenter cohort study included adult kidney transplant recipients (KTRs) admitted to five major tertiary hospitals in Korea between 1997 and 2012. A total of 3,565 adult participants were enrolled. Patient survival, allograft survival, and biopsy-proven acute rejection (BPAR) of 242 elderly recipients (≥60 years) were assessed and compared with those of a younger population. Results Patients were divided into five groups according to age at time of transplantation. The proportion of elderly patients was 6.7 % (mean age, 63.1 ± 2.7 years; n = 242). The numbers of male patients (69.4%), those with diabetes mellitus history (36.3%), and those with pretransplantation ischemic heart disease history (17.7%) were significantly higher in the elderly group than in the younger age groups. Elderly patients were more likely to receive a cadaveric kidney, and overall mortality rates were significantly higher in the elderly patients (1-year survival 93.3%, 5-year survival 91.3%). However, death-censored allograft survival rate and BPAR were not affected by patient age (P =.104 and.501, respectively). Among the elderly, BPAR and female donors were independent risk factors for allograft loss. Conclusion The overall survival rate of the elderly KTRs was significantly lower than that of younger KTRs. However, the death-censored allograft survival rate did not differ between groups. Kidney transplantation should not be stagnated especially in elderly patients with end-stage renal disease.
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U2 - 10.1016/j.transproceed.2015.01.021
DO - 10.1016/j.transproceed.2015.01.021
M3 - Article
C2 - 25891695
AN - SCOPUS:84928324785
SN - 0041-1345
VL - 47
SP - 600
EP - 607
JO - Transplantation Proceedings
JF - Transplantation Proceedings
IS - 3
ER -
