title: Prognostic factors in kidney transplantation in the septuagenarian: a multicenter analysis.
abstract: Kidney transplant (KT) programs have extended recipient eligibility to those who were previously excluded due to advanced age. We aimed to determine the outcomes of the patients ≥70 years undergoing KT and investigate factors predicting survival. Two thousand six hundred and twenty-four KT patients between 2003 and 2013 at two institutions were divided into two groups; those ≥70 years (n=300) and those <70 years (n=2324) at the time of KT. Patient survival at 1, 3, and 5 years was 95%, 86%, and 77% in ≥70 years of age group and 98%, 95%, and 90% in the <70 years group (P<.001). When graft loss due to death was censored, graft survival was not significantly different between the two groups (P=.18). On multivariable analysis, the significant predictors of inferior survival in patients ≥70 years included: body mass index (BMI)>30 kg/m(2) (hazard ratio [HR] 1.07; P=.01), panel reactive antibody (PRA)>20% (HR 2.38; P=.01), previous coronary artery bypass grafting (CABG; HR 1.95; P=.03) and peripheral vascular disease (PVD; HR 2.60; P=.04). Acceptable outcomes can be achieved in KT recipients ≥70 years. Caution should be used when listing these patients if they have BMI>30 kg/m(2) , PRA>20%, CABG or PVD.
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL, USA.
authors.forename: Hector
authors.initials: H
authors.lastname: Saucedo-Crespo
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Danielle J
authors.initials: DJ
authors.lastname: Haakinson
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL, USA.
authors.forename: Kristopher P
authors.initials: KP
authors.lastname: Croome
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL, USA.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Mai
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL, USA.
authors.forename: C Burcin
authors.initials: CB
authors.lastname: Taner
authors.affiliation: Department of Medicine, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Heilman
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gonwa
mesh_terms: D000368:Aged; D001130:Arizona / Q000453:epidemiology; D015992:Body Mass Index; D005260:Female; D005431:Florida / Q000453:epidemiology; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D015994:Incidence; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
keywords: elderly; graft loss; kidney transplantation; mortality