title: Advanced age is not an exclusion criterion for kidney transplantation.
abstract: BACKGROUND
  Renal transplantation in patients older than 60 years has long been regarded with skepticism owing to the increased risk of complications although, as compared with dialysis treatment, a graft seems to improve not only the quality of life but also long-term patient survival. This study sought to analyze the impact of recipient age older than 60 years on patient and graft outcomes.
  
  
  METHODS
  We retrospectively investigated the outcomes of 761 kidney transplant recipients from cadaveric donors performed between February 1998 and July 2011. While 69 subjects were at least 60 years of age (group A), 692 were younger than 60 years (group B) at the time of transplantation.
  
  
  RESULTS
  Mean follow-up was 60.1 ± 38.5 months. Delayed graft function (DGF) requiring dialysis was observed in 36 group A (52.1%) and 205 group B (29.6%) subjects (P = .001). However, there were also significant differences between group A and group B in terms of mean donor age (60.3 vs 44.6 years; P < .001) and mean donor estimated creatinine clearance (57.8 vs 83.4 mL/min; P < .001). There were no significant differences in death-censored graft survival between the two groups, but elderly patients experienced worse survival (P = .0005). The most common causes of patient death were myocardial infarction, other cardiovascular complications, and tumors.
  
  
  CONCLUSIONS
  Kidney transplantation is a good option for elderly recipients with end-stage renal disease, providing long graft survival and a good quality of life, although these patients are more likely to develop cancer or cardiovascular disease. Our findings suggested that older patients should not be excluded a priori from transplantation, but meticulous screening for cancer and heart disease should be always be performed to improve outcomes.
authors.affiliation: Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy. Electronic address: stefanovittorio@gmail.com.
authors.forename: S V
authors.initials: SV
authors.lastname: Impedovo
authors.forename: P
authors.initials: P
authors.lastname: Ditonno
authors.forename: V
authors.initials: V
authors.lastname: Ricapito
authors.forename: C
authors.initials: C
authors.lastname: Bettocchi
authors.forename: L
authors.initials: L
authors.lastname: Gesualdo
authors.forename: G
authors.initials: G
authors.lastname: Grandaliano
authors.forename: F P
authors.initials: FP
authors.lastname: Selvaggi
authors.forename: M
authors.initials: M
authors.lastname: Battaglia
mesh_terms: D000367:Age Factors; D005787:Gene Frequency; D006801:Humans; D016030:Kidney Transplantation; D016133:Polymerase Chain Reaction; D020641:Polymorphism, Single Nucleotide