Survival benefit of renal transplantation in octogenarians

Clin Transplant. 2020 Nov;34(11):e14074. doi: 10.1111/ctr.14074. Epub 2020 Sep 27.

Abstract

Background: Elderly patients are the fastest growing population requiring renal replacement therapy. As previous studies have shown a survival benefit of kidney transplantation compared to dialysis for end-stage renal disease, we sought to evaluate if this survival benefit extends to octogenarians.

Methods: This was a single-center retrospective cohort study of renal allograft recipients ≥80 years transplanted from 1999 to 2014 who were compared to patients listed during the same period that did not proceed to transplantation. A secondary matched group was selected from the UNOS transplant waitlist database. The primary outcome was patient survival. Secondary outcomes included graft survival and rejection incidence.

Results: Thirty-three transplanted patients were compared to 71 patients waitlisted at our center and 66 patients from the UNOS database. Patients in the study group were transplanted 20.8 ± 16.1 months after listing. Patient survival was 87.8% at 6 months and 1 year and 71.4% at 3 years. Kidney transplantation was associated with a significant decrease in the risk of death after listing (HR: 0.22, CI: 0.11-0.45, P < .001).

Conclusion: With escalating life expectancy, kidney transplantation is a suitable treatment option in eligible octogenarians.

Keywords: dialysis; elderly; graft survival; kidney transplantation; patient survival; rejection.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Graft Rejection / etiology
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic* / surgery
  • Kidney Transplantation*
  • Renal Dialysis
  • Retrospective Studies
  • Survival Rate