title: Renal transplantation in the elderly: surgical complications and outcome with special emphasis on the Eurotransplant Senior Programme.
abstract: BACKGROUND
  The purpose of this retrospective study was to evaluate the results of the Eurotransplant Senior Programme (ESP) within our centre compared to elderly recipients >or=60 years from the regular Eurotransplant Kidney Allocation System (ETKAS), specifically focusing on surgical aspects.
  
  
  METHODS
  Data from 73 ESP patients (average donor/recipient age: 71.1/67.1) were compared with those from 51 patients (49.7/63.6) treated within the framework of the ETKAS program between the years 1999 and 2006. The mean follow-up was 39.5 months.
  
  
  RESULTS
  Cold ischaemic time (ESP versus ETKAS: 10.3 versus 15.0 h), duration of renal replacement therapy (42.2 versus 76.8 months), donor glomerular filtration rate (81.7 versus 109.9 ml/min/1.73 m(2)) and HLA mismatches (4.1 versus 2.4) were significantly different between the two groups (all P < 0.001). Primary graft function was seen in 74% ESP versus 69% of ETKAS patients (P > 0.05). The rate of surgical complications in the ESP versus ETKAS group was 47% versus 28% (P = 0.031) and the revision rate, 33% versus 24% (P = 0.259). Three-year patient and censored graft survival was 84% versus 92% and 85% versus 88% in the ESP and ETKAS group, respectively (all P > 0.05). Ninety-five percent of all deceased patients died with a functioning graft.
  
  
  CONCLUSIONS
  The donor and recipient pool has been markedly expanded through ESP with similar patient and graft survival compared to elderly recipients grafted according to ETKAS criteria. However, patients and their physicians should be aware of the high surgical complication rate in elderly recipients, particularly when receiving elderly donor kidneys. This might seriously influence postoperative patient management but ultimately does not compromise the transplant outcome.
authors.affiliation: Department of Urology and Paediatric Urology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany. Bentas@em.uni-frankfurt.de
authors.forename: Wassilios
authors.initials: W
authors.lastname: Bentas
authors.forename: Jon
authors.initials: J
authors.lastname: Jones
authors.forename: Akay
authors.initials: A
authors.lastname: Karaoguz
authors.forename: Ursula
authors.initials: U
authors.lastname: Tilp
authors.forename: Michael
authors.initials: M
authors.lastname: Probst
authors.forename: Ernst
authors.initials: E
authors.lastname: Scheuermann
authors.forename: Ingeborg A
authors.initials: IA
authors.lastname: Hauser
authors.forename: Dietger
authors.initials: D
authors.lastname: Jonas
authors.forename: Jan
authors.initials: J
authors.lastname: Gossmann
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D005858:Germany; D006084:Graft Rejection / Q000401:mortality*; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D011183:Postoperative Complications / Q000401:mortality* / Q000503:physiopathology; D011336:Probability; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*