KIDNEY TRANSPLANT IN ELDERLY PATIENTS. SHOULD WE KEEP ON GOING?

8 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-3090, Poster Board= SAT-464

Introduction:

The aim was to assess the impact of age on graft and overall survival (SV) after kidney transplant in a cohort with up to 10 years of follow-up. 

Methods:

A retrospective cohort study was carried out including 250 kidney transplant recipients consecutively operated between 2010 and 2012. Multiorganic transplants and both dead-donor and living-donor transplants were included. Data were collected from electronic health records. For analysis purposes the sample was divided into 4 age groups: ≤ 60 years (n=163), 61-65 years (n=45), 66-70 years (n=31) and > 70 years (n=11). A comparative survival analysis was performed using the Kaplan-Meier method with log-rank tests. The threshold for statistical significance was set at 0.05 (Bonferroni correction applied for multiple comparisons). 

Results:

Baseline characteristics were comparable among groups except for multiorganic transplant that were exclusively performed in the youngest group. We observed higher incidences of intraoperative complications (p=0.015), graft delayed function (p=0.003), cardiovascular events (p<0.001) and tumor diagnosis (p<0.001) in older patients. Further data on complications observed during follow-up did not show statistical differences between groups (acute rejection, chronic rejection, opportunistic infection, bacterial infection and incidence of urological tumors). The actuarial probability of graft and overall survival at 5 and 10 years is shown in table 1. Statistically significant differences in survival curves distributions were observed (p=0.08 and p<0.001 respectively).

 

< 60y

61-65y

66-70y

>70y

Graft SV

       

At 5y

86%

90,8%

73%

81,8%

At 10y

80,5%

88,1%

58,7%

54,5%

Overall SV

       

At 5y

91,7%

90,9%

75,8%

100%

At 10y

88,4%

66,3%

42,3%

40%

         

Post-hoc analysis revealed main differences for graft survival between 66-70 years group and all younger patients (SV at 5 and 10 years 73% and 58.7% vs 87.1% and 82.2% respectively, p=0.002). For overall survival major differences were identified between ≤ 60 years group and all older groups (SV at 5 and 10 years 91.7% and 88.4% vs 86.7% and 54.8% respectively, p<0.001). 

Conclusions:

An older recipient age is associated with a higher risk of implant loss and a lower overall survival after kidney transplant. 

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.