Renal transplantation for patients 60 years of older. A single-institution experience.
OBJECTIVE
The authors reviewed renal transplant outcomes in recipients 60 years of age or older.


BACKGROUND
Before cyclosporine, patients older than 45 years of age were considered to be at high risk for transplantation. With cyclosporine, the age limits for transplantation have expanded.


METHODS
The authors compared patient and graft survival, hospital stay, the incidence of rejection and rehospitalization, and the cause of graft loss for primary kidney recipients 60 years of age or older versus those 18 to 59 years of age. For those patients > or = 60 years transplanted since 1985, the authors analyzed pretransplant extrarenal disease and its impact on post-transplant outcome. In addition, all surviving recipients > or = 60 years completed a medical outcome survey (SF-36).


RESULTS
Patient and graft survival for those > or = 60 years of age versus those 18 to 59 years of age were similar 3 years after transplant. Subsequently, mortality increased for the older recipients. Death-censored graft survival was identical in the two groups. There were no differences in the cause of graft loss. Those 60 years of age or older had a longer initial hospitalization, but had fewer rejection episodes and fewer rehospitalizations. Quality of life for recipients 60 years of age or older was similar to the age-matched U.S. population.


CONCLUSIONS
Renal transplantation is successful for recipients 60 years of age or older. Most of them had extrarenal disease at the time of transplantation; however, extrarenal disease was not an important predictor of outcome and should not be used as an exclusion criterion. Post-transplant quality of life is excellent.
Benedetti
E
E
Department of Surgery, University of Minnesota, Minneapolis 55455.
Matas
A J
AJ
Hakim
N
N
Fasola
C
C
Gillingham
K
K
McHugh
L
L
Najarian
J S
JS
D000328:Adult; D000367:Age Factors; D016572:Cyclosporine / Q000627:therapeutic use; D003625:Data Collection / Q000379:methods; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy; D015994:Incidence; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D011788:Quality of Life; D012086:Reoperation; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
D016572:Cyclosporine