title: Outcomes following renal transplantation in older renal transplant recipients: a single-center experience and "Croatian senior program".
abstract: OBJECTIVE
  Outcomes of kidney transplantation in older patients have not, however, been fully defined. The aims of this study were to analyze the number of new end-stage renal disease (ESRD) patients ≥65 years of age who were managed with kidney transplantation and their survival through the study period. In addition, we have analyzed post-transplantation outcomes in younger and older renal transplant recipients (RTRs).
  
  
  METHODS
  We have analyzed the mean age of 505 RTRs transplanted between January 1990 and December 2013. Older people were defined as aging 65 years or older. Of 505 RTRs, there were 73 (14.5 %) patients who were ≥65 years of age. Therefore, in further analysis, patients were divided into two subgroups: younger recipients (younger than 65 years) and older recipients (aging 65 years or older).
  
  
  RESULTS
  In the period from 1990 to 2001, patients who were 65 years of age and older were only sporadically treated with kidney transplantation in Croatia. Since 2002, the number of patients older than 65 years undergoing renal transplantation has been increasing. The older recipients were more likely to receive organs from older donors (52.6 ± 16.8 vs. 45.8 ± 13.2; p = 0.0001). There were no significant differences due to HLA mismatch between the two groups of analyzed patients. There was no difference in the rates of DGF between the older and younger recipients. Older recipients were less likely than younger recipients to have acute rejection crisis during the first-ear after transplantation (16.4 vs. 34.7 %; p = 0.03). There were no significant differences due to readmission rates in the first-year post-transplantation between the two groups. There was no significant difference due to graft function and 1-year graft and patient's survival between young and older recipients. Serum creatinine values at 1 year were higher in older recipients who received kidneys from elderly donor.
  
  
  CONCLUSIONS
  Our experience supports the use of kidney transplantation in the population of older ESRD patients. We can increase patients and graft survivals in elderly individuals with careful pre-transplant evaluation and HLA matching. "Croatian senior program" that includes HLA matching represents a good approach for kidney transplantation in older ESRD patients.
authors.affiliation: Department of Nephrology, Dialysis and Kidney Transplantation, UHC Rijeka, Tome Strižića 3, 51000, Rijeka, Croatia, ivana.mikolasevic@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Mikolasevic
authors.forename: S
authors.initials: S
authors.lastname: Racki
authors.forename: J
authors.initials: J
authors.lastname: Spanjol
authors.forename: Z
authors.initials: Z
authors.lastname: Zupan
authors.forename: I
authors.initials: I
authors.lastname: Jakopcic
authors.forename: B
authors.initials: B
authors.lastname: Devcic
authors.forename: L
authors.initials: L
authors.lastname: Orlic
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017523:Croatia; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006084:Graft Rejection / Q000453:epidemiology*; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D066027:Transplant Recipients; D055815:Young Adult