Kidney Transplant Outcomes in elderly Recipients: An Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry Study.


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Historique:
received: 27 03 2021
accepted: 14 06 2021
pubmed: 20 7 2021
medline: 21 10 2021
entrez: 19 7 2021
Statut: ppublish

Résumé

There is an increase in elderly patients receiving kidney transplant internationally. This study describes elderly kidney transplant recipient outcomes in Australia and New Zealand. The study included all adult first kidney transplant recipients in Australia and New Zealand from 2000 to 2015. Survival and graft outcomes were compared between elderly (≥70 years) and younger (18-69 years) recipients using Cox proportional hazards regression. Overall, 10651 kidney transplant recipients were included, of which 279 (2.6%) were elderly adults. The proportion of elderly recipients increased from 0.6 to 4.4% from 2000 to 2015. Compared with younger recipients, elderly recipients were more likely to receive kidneys from deceased donors, elderly donors, and expanded criteria donors. Elderly recipients experienced poorer patient survival with 1- and 5-year survival ranging from 96% to 97% and 79% to 81%, respectively, compared with 97% to 99% and 90% 95% in younger recipients, respectively. Elderly recipients experienced comparable rates of delayed graft function and, in living donor kidney recipients, lower rates of acute rejection. Kidney transplantation in the elderly population is increasing. Although elderly recipients had inferior survival and graft outcomes, elderly recipients generally received poorer quality kidneys. The outcomes achieved in this cohort of elderly adults are encouraging, and improving elderly recipient outcomes should be an important focus for research.

Sections du résumé

BACKGROUND BACKGROUND
There is an increase in elderly patients receiving kidney transplant internationally. This study describes elderly kidney transplant recipient outcomes in Australia and New Zealand.
METHODS METHODS
The study included all adult first kidney transplant recipients in Australia and New Zealand from 2000 to 2015. Survival and graft outcomes were compared between elderly (≥70 years) and younger (18-69 years) recipients using Cox proportional hazards regression.
RESULTS RESULTS
Overall, 10651 kidney transplant recipients were included, of which 279 (2.6%) were elderly adults. The proportion of elderly recipients increased from 0.6 to 4.4% from 2000 to 2015. Compared with younger recipients, elderly recipients were more likely to receive kidneys from deceased donors, elderly donors, and expanded criteria donors. Elderly recipients experienced poorer patient survival with 1- and 5-year survival ranging from 96% to 97% and 79% to 81%, respectively, compared with 97% to 99% and 90% 95% in younger recipients, respectively. Elderly recipients experienced comparable rates of delayed graft function and, in living donor kidney recipients, lower rates of acute rejection.
CONCLUSIONS CONCLUSIONS
Kidney transplantation in the elderly population is increasing. Although elderly recipients had inferior survival and graft outcomes, elderly recipients generally received poorer quality kidneys. The outcomes achieved in this cohort of elderly adults are encouraging, and improving elderly recipient outcomes should be an important focus for research.

Identifiants

pubmed: 34275599
pii: S0041-1345(21)00444-9
doi: 10.1016/j.transproceed.2021.06.024
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1915-1926

Informations de copyright

Crown Copyright © 2021. Published by Elsevier Inc. All rights reserved.

Auteurs

Brian Percy Doucet (BP)

Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; School of Clinical Medicine, The University of Queensland, Brisbane, Queensland, Australia. Electronic address: brian.doucet@uqconnect.edu.au.

Yeoungjee Cho (Y)

Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia.

Scott Bryan Campbell (SB)

Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Centre for Kidney Disease Research, The University of Queensland, Brisbane, Queensland, Australia.

David Wayne Johnson (DW)

Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia; Centre for Kidney Disease Research, The University of Queensland, Brisbane, Queensland, Australia.

Carmel Mary Hawley (CM)

Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, Queensland, Australia; Centre for Kidney Disease Research, The University of Queensland, Brisbane, Queensland, Australia; Australia and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia.

Armando Rogerió Martins Teixeira-Pinto (ARM)

Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; School of Public Health, University of Sydney, Sydney, New South Wales, Australia.

Nicole Maree Isbel (NM)

Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia; Centre for Kidney Disease Research, The University of Queensland, Brisbane, Queensland, Australia.

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