Cadaveric renal transplantation with cyclosporine in patients more than 60 years of age.
Advanced age has been a relative contraindication to kidney transplantation because of the likelihood of increased morbidity and mortality in the geriatric population. However, the introduction of cyclosporine has improved renal allograft survival rates dramatically, and higher-risk patients are now being successfully transplanted. With the introduction of cyclosporine in 1983, we have performed 36 cadaveric renal transplants in 34 recipients 60 years of age or older, including 34 primary and 2 retransplants. Most of the patients (88%) were on dialysis prior to transplantation and 29% had ASCVD. Three-year actuarial patient and allograft survival are 91% and 74%, respectively. Surgical complications were infrequent, and postoperative rejection episodes were less frequent than in younger patients but were more likely to lead to graft loss. Medical complications, especially infection, were common after transplantation but easily managed. Cadaveric renal transplantation with cyclosporine immunosuppression is a safe and effective therapeutic modality that is no longer contraindicated in elderly patients.
Pirsch
J D
JD
University of Wisconsin School of Medicine, Department of Surgery, Madison 53792.
Stratta
R J
RJ
Armbrust
M J
MJ
D'Alessandro
A M
AM
Sollinger
H W
HW
Kalayoglu
M
M
Belzer
F O
FO
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D003524:Cyclosporins / Q000627:therapeutic use*; D003928:Diabetic Nephropathies / Q000139:chemically induced; D005260:Female; D006085:Graft Survival / Q000187:drug effects; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D007239:Infections / Q000209:etiology; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology
D003524:Cyclosporins