title: Clinical Outcome of Elderly Kidney Transplant Recipients from Spousal Donors.
abstract: BACKGROUND
  Patients aged 60 years and older stand for the fastest growing group of patients with end-stage renal disease worldwide, and the need for kidney transplants among this population is rising. In Japan, living donor kidney transplantation is mainly performed to deal with the severe shortage of deceased donors, and the number of spousal transplants is currently increasing.
  
  
  METHODS
  A total of 164 patients with ESRD underwent living donor kidney transplantation at our institution, of whom 21 patients aged 60 years and older had spousal kidney transplantation. ABO-incompatible kidney transplantation was performed in 5 of the 21 cases. We analyzed these recipients.
  
  
  RESULTS
  Patient and graft survival rates were 100%. The incidence of acute rejection was 23.8%. Eight patients experienced cytomegalovirus viremia, two patients experienced Pneumocystis jiroveci infection, and one experienced bacterial pneumonia. Two patients developed cancers and underwent curative operation after transplantation.
  
  
  CONCLUSIONS
  Elderly kidney transplantation from spousal donors is associated with age-related immune dysfunction, which may develop infections and malignancies and could be immunologically high risk due to the high rate of ABO-incompatibility and poor histocompatibility. An effort to minimize the adverse effect of immunosuppression and to reduce the risk of acute rejection may be needed for an excellent long-term outcome.
authors: Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors: Tomoaki
authors: T
authors: Iwai
authors: Junji
authors: J
authors: Uchida
authors: Nobuyuki
authors: N
authors: Kuwabara
authors: Kazuya
authors: K
authors: Kabei
authors: Nao
authors: N
authors: Yukimatsu
authors: Motohiro
authors: M
authors: Okamura
authors: Takeshi
authors: T
authors: Yamasaki
authors: Toshihide
authors: T
authors: Naganuma
authors: Norihiko
authors: N
authors: Kumada
authors: Tatsuya
authors: T
authors: Nakatani
mesh_terms: D000017:ABO Blood-Group System; D000368:Aged; D001787:Blood Group Incompatibility; D003586:Cytomegalovirus Infections / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007564:Japan; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018454:Spouses; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents