title: Outcome of kidney transplantation under tacrolimus-based immunosuppression in elderly patients.
abstract: Kidney transplantation has become a reasonable treatment option for selected patients aged 60 years or older, and a number of different immunosuppressive drug protocols have been described. This article concerns 230 recipients who were aged 60 years or older and who were undergoing kidney-only transplantation at the University of Pittsburgh between January 1990 and April 1997. All recipients were treated with a tacrolimus-based immunosuppression regimen. The median follow-up was 31.5 months (range, 1-86). The 1-, 3-, and 5-year actuarial patient survival rates were 90%, 83%, and 76%, respectively. There were 42 (19%) deaths, cardiovascular disease (50%) and infection (38%) being the main causes. Death with a functioning kidney occurred in 28 (67%) patients. The 1-, 3-, and 5-year actuarial graft survival rates were 84%, 74%, and 64%, respectively. The delayed graft function rate was 33%. Rejection was seen in 57 (25%) elderly patients. The mean serum creatinine was 2.6 +/- 2.7 mg/dL and the serum urea nitrogen was 35 +/- 22 mg/dL. The mean tacrolimus level was 8.5 +/- 3.8 ng/mL. These results suggest that renal transplantation in older recipients under tacrolimus-based immunosuppression is associated with reasonable outcomes, and can be offered to appropriately selected patients.
authors.affiliation: Department of Critical Care Medicine, University of Pittsburgh, Pa., USA.
authors.forename: A
authors.initials: A
authors.lastname: Soran
authors.forename: R
authors.initials: R
authors.lastname: Shapiro
authors.forename: H
authors.initials: H
authors.lastname: Basar
authors.forename: C
authors.initials: C
authors.lastname: Vivas
authors.forename: V P
authors.initials: VP
authors.lastname: Scantlebury
authors.forename: M L
authors.initials: ML
authors.lastname: Jordan
authors.forename: H A
authors.initials: HA
authors.lastname: Gritsch
authors.forename: J
authors.initials: J
authors.lastname: McCauley
authors.forename: P
authors.initials: P
authors.lastname: Randhawa
authors.forename: T R
authors.initials: TR
authors.lastname: Hakala
authors.forename: J J
authors.initials: JJ
authors.lastname: Fung
mesh_terms: D000206:Actuarial Analysis; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000601:surgery; D016030:Kidney Transplantation / Q000276:immunology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016559:Tacrolimus / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus