title: Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation?
abstract: BACKGROUND
  Elderly patients are the fastest-growing group in need of renal transplantation. This study puts focus on renal transplant recipients in their 80th year or longer at time of engraftment. Is there evidence to support an absolute upper age limit for renal transplantation?
  
  
  METHODS
  Recipients in their 80th year or longer, transplanted between 1983 and 2015, were included. Data were retrieved from the Norwegian Renal Registry in the end of October 2015. Graft and patient survivals were compared with recipients aged 70 to 79 years at transplantation.
  
  
  RESULTS
  Forty-seven patients older than 79 years were transplanted in the defined period. Median age 80.1 years, 81% were men. Median time on dialysis before transplantation was 18.5 months. All patients received an allograft from a deceased donor (median donor age, 61.8 years). In the death-censored graft survival model, there was no statistical difference between the groups. We found improved patient and graft survivals after introduction of mycophenolate mofetil and induction with basiliximab. Patients transplanted before 2000 had increased risk of death compared with those transplanted after 2000 (hazard ratio, 3.2; 95% confidence interval, 1.2-8.7). Median uncensored graft survival for patients transplanted after the year 2000 was 5.0 year (95% confidence interval, 2.4-7.6). Median patient survival was 5.0 years (3.1-6.9) and 5-year patient survival was 55%.
  
  
  CONCLUSIONS
  Age by itself should not be an absolute contraindication against renal transplantation. An estimated 5-year survival rate of 55% post-engraftment for an 80-year-old patient is in our opinion more than acceptable.
authors.affiliation: 1 Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 2 Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 3 Clinic of Internal Medicine, Telemark Hospital, Skien, Norway.
authors.forename: Kjersti
authors.initials: K
authors.lastname: Lønning
authors.forename: Karsten
authors.initials: K
authors.lastname: Midtvedt
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Leivestad
authors.forename: Anna V
authors.initials: AV
authors.lastname: Reisæter
authors.forename: Pål-Dag
authors.initials: PD
authors.lastname: Line
authors.forename: Anders
authors.initials: A
authors.lastname: Hartmann
authors.forename: Kristian
authors.initials: K
authors.lastname: Heldal
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006084:Graft Rejection / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000601:surgery*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D018579:Patient Selection; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D013997:Time Factors; D066027:Transplant Recipients; D016896:Treatment Outcome