title: Outcomes of renal transplantation in older high risk recipients: is there an age effect?
abstract: BACKGROUND
  The purpose of this study was to evaluate long-term outcomes in high risk renal transplant recipients over 60 years of age compared with those younger than 60 years of age.
  
  
  METHODS
  We analyzed outcomes in 131 consecutive renal transplant recipients at our institution between November 2001 and December 2007. Primary outcomes included incidence of delayed graft function (DGF), acute rejection, graft survival, patient survival, and incidence of infections and neoplasms.
  
  
  RESULTS
  Older recipients (Over 60 group, n = 45) received more organs from extended criteria donors (ECD) or donation after cardiac death donors (DCD) compared with younger recipients (Under 60 group, n = 86), 42% versus 17% respectively, P = 0.001. Multivariate analyses revealed that African American ethnicity and DCD donation had the greatest impact on the incidence of DGF in both groups; P < 0.05. Patient survival and graft survival beyond 1 y were similar between the two groups.
  
  
  CONCLUSIONS
  Our data suggest that long-term transplant outcomes in older, high risk renal transplant recipients are similar to those of younger, high risk recipients. Older recipients' age and high-risk characteristics, such as African American ethnicity and increased sensitization, should not be a contraindication to renal transplantation in the elderly.
authors.affiliation: Temple University School of Medicinem, Philadelphia, Pennsylvania 19140, USA.
authors.forename: Andreas
authors.initials: A
authors.lastname: Karachristos
authors.forename: Argenis
authors.initials: A
authors.lastname: Herrera
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Sifontis
authors.forename: Justin
authors.initials: J
authors.lastname: Darrah
authors.forename: Craig
authors.initials: C
authors.lastname: Baribault
authors.forename: Iris
authors.initials: I
authors.lastname: Lee
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Leech
authors.forename: Serban
authors.initials: S
authors.lastname: Constantinescu
authors.forename: John
authors.initials: J
authors.lastname: Gaughan
authors.forename: Ashokkumar
authors.initials: A
authors.lastname: Jain
authors.forename: Patricio
authors.initials: P
authors.lastname: Silva
authors.forename: John A
authors.initials: JA
authors.lastname: Daller
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D002102:Cadaver; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function; D005006:Ethnicity; D005260:Female; D006085:Graft Survival; D006801:Humans; D007239:Infections / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors; D001741:Black or African American
chemical_list: D003404:Creatinine