title: Risk variables associated with the outcome of kidney recipients >70 years of age in the new millennium.
abstract: BACKGROUND
  New and more potent immunosuppressive protocols have markedly reduced the occurrence of rejections following organ transplantation. Accordingly, survival of elderly kidney transplant recipients has been substantially improved in the new millennium. The present study was performed to identify variables associated with the outcome of kidney transplant recipients >70 years of age in the modern era.
  
  
  METHODS
  A single center retrospective study was performed, evaluating clinical and survival data from all patients >70 years of age receiving their first kidney transplant between 2000 and 2005. Survival data were analyzed using Cox proportional hazard models and the Kaplan-Meier method.
  
  
  RESULTS
  During the time period, 160 recipients >70 years of age received their first transplant. The following factors were negatively associated with patient survival: age at transplantation; hazard ratio (HR) 1.09 per year, 95% confidence interval (CI) (1.01-1.18), time on dialysis before transplantation; HR 1.29 per year 95% CI (1.06-1.59) and presence of diabetes at transplantation; HR 1.78 95% CI (1.00-3.16). Thirty-five patients (22%) experienced an acute rejection episode during the first 90 days post-transplant. Acute rejection episodes did not influence on patient or graft survival. Patients with post-transplant pathological oral glucose tolerance test (OGTT) at 10 weeks after transplantation had significantly inferior survival compared to patients with normal OGTT.
  
  
  CONCLUSIONS
  In a population of kidney transplant recipients >70 years of age with relatively low incidence of acute rejection episodes, age, time on dialysis before transplantation, concomitant diabetes mellitus and development of a pathological OGTT 10 weeks after transplantation were associated with inferior patient survival.
authors.affiliation: Section of Cardiology, Nephrology and Endocrinology, Clinic of Internal Medicine, Sykehuset Telemark, Skien, Norway. kristian.heldal@sthf.no
authors.forename: Kristian
authors.initials: K
authors.lastname: Heldal
authors.forename: Anders
authors.initials: A
authors.lastname: Hartmann
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Leivestad
authors.forename: Aksel
authors.initials: A
authors.lastname: Foss
authors.forename: Karsten
authors.initials: K
authors.lastname: Midtvedt
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome