RENAL-TRANSPLANTATION FOR PATIENTS 60 YEARS OF AGE OR OLDER - A SINGLE-INSTITUTION EXPERIENCE

Objective The authors reviewed renal transplant outcomes in recipients 60 years of age or older. Background Before cyclosporine, patients older than 45 years of age were considered to be al high risk for transplantation. With cyclosporine, the age limits for transplantation have expanded. Methods The authors compared patient and graft survival, hospital stay, the incidence of rejection and rehospitalization, and the cause of graft loss for primary kidney recipients 60 years of age or older versus those 18 to 59 years of age. For those patients greater than or equal to 60 years transplanted since 1985, the authors analyzed pretransplant extrarenal disease and its impact on post-transplant outcome. In addition, all surviving recipients greater than or equal to 60 years completed a medical outcome survey (SF-36). Results Patient and graft survival for those greater than or equal to 60 years of age versus those 18 to 59 years of age were similar 3 years after transplant. Subsequently, mortality increased for the older recipients. Death-censored graft survival was identical in the two groups. There were no differences in the cause of graft loss. Those 60 years of age or older had a longer initial hospitalization, but had fewer rejection episodes and fewer rehospitalizations. Quality of life for recipients 60 years of age or older was similar to the age-matched U.S. population. Conclusion Renal transplantation is successful for recipients 60 years of age or older. Most of them had extrarenal disease at the time of transplantation; however, extrarenal disease was not an important predictor of outcome and should not be used as an exclusion criterion. Post-transplant quality of life is excellent.