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Nephrol Dial Transplant (2001) 16: 824-828
© 2001 European Renal Association-European Dialysis and Transplant Association

Renal transplantation in the elderly: a long-term, single-centre experience

Patrick Saudan1, Thierry Berney2, Michel Leski1, Philippe Morel2, Jean-François Bolle1 and Pierre-Yves Martin,2

1 Division of Nephrology, Department of Medicine and 2 Clinic of Visceral and Transplantation Surgery, University Hospital, Geneva, Switzerland

Background. End-stage renal failure increases with advancing age and renal transplantation should be considered in end-stage renal failure patients older than 60 years. However, there is a paucity of data on long-term patient and graft survival in this population.

Methods. From October 1983 to March 1999, 310 renal transplantations were performed at Geneva University Hospital in 283 patients, of which 49 were done in 48 patients older than 60 years (mean age 65.6±4.1 years). The following data were analysed at 1, 5, and 10 years, and compared between the patients >60 years and <60 years old: actuarial patient and graft survival, serum creatinine, causes of graft loss, and patient death.

Results.  Patient survival at 10 years was 81% for patients <60 years and 44% for patients >60 years. Graft survival at 10 years was 59% for patients <60 years and 32% for patients >60 years. Graft survival at 10 years censored for death with functioning graft was 65% for patients <60 years and 81% for patients >60 years. Main causes of mortality in the older patients were related to cardiovascular events (47%), neoplasia (41%), and sepsis (18%). Overall, recipient and donor age were not predictive factors for graft survival, as shown by multiple logistic regression.

Conclusions. Renal transplantation should be considered in patients older than 60 years, since graft survival is excellent in this population. Although these patients have a shorter life expectancy, they benefit from renal transplantation similarly to younger kidney transplant recipients.

Keywords: elderly; end-stage renal disease; haemodialysis; kidney graft failure; renal transplantation; retrospective study; survival

Correspondence and offprint requests to: Pierre-Yves Martin MD, Nephrology Division, Department of Internal Medicine, Geneva University Hospital, 24 Rue Micheli-Du-Crest, CH-1211 Geneva 14, Switzerland.


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