Renal Transplant Outcomes in Elderly Recipients: Age Alone Should Not Be a Barrier

Document Type

Conference Proceeding

Publication Date

8-2-2025

Publication Title

Am J Transplant

Abstract

Purpose: Elderly patients undergo fewer renal transplants due to concerns of increased mortality. We compared outcomes and risk factors for graft loss and mortality in our program’s elderly recipients to evaluate these concerns and inform decision-making. Methods: Retrospective analysis of recipients from 1/2013 to 6/2022. Those aged 65 years (yrs.) and older who received primary renal transplants were included. Recipients were grouped into younger (RY; age 65-70 yrs.) and older (RO; age 70+ yrs.). Baseline recipient and donor variables and transplant outcomes were compared between the groups. Primary outcomes of interest were patient survival (PS) and graft survival (GS). Kaplan-Meier (KM) survival analysis and multivariate Cox regression analysis was performed on all variables with censoring date 11/26/23. Results: 199 recipients were included; 116 were RY, 83 were RO. RY had higher preoperative serum albumin, shorter EPTS, and higher rates of hypertension (HTN), ischemic heart disease (IHD), and vascular disease (PVD). More RO had no induction agent and had a donor with diabetes (DM). Foley duration was longer and hydronephrosis rate was higher in RY, while RO had a higher rate of urine leak. Other characteristics and posttransplant complications did not differ significantly between groups (Table 1). [Formula presented] RY and RO had similar KM probabilities of 1-10 year GS (p=0.21 - 0.91) and PS (p=0.23 - 0.95). Median GS was longer in RY (8.5 vs 6.4 yrs., p=0.08), as was PS (8.9 vs 7.2 yrs., p=0.05). Median GS was similar between groups (8.5 vs 6.4 yrs., p=0.08), while PS was longer in RY (8.9 vs 7.2 yrs., p=0.05). On multivariate analysis, higher 1-year serum creatinine was significantly associated with graft loss in both groups. Recipient DM, IHD, and DGF was associated with risk of graft loss and patient mortality for RY, while higher serum albumin was associated with lower risk for both outcomes for RO. Induction with Simulect (vs. no agent) was associated with lower risk for patient mortality for RO (Figure 1). [Formula presented] Conclusions: Despite differences in baseline characteristics, we found comparable GS and PS between RY and RO groups, indicating that older age should not be a barrier to transplantation. Future analysis will include waitlisted and dialysis patients. CITATION INFORMATION: Lu Z., Kumar V., Kumaresan K., Prashar R., Patel A. Renal Transplant Outcomes in Elderly Recipients: Age Alone Should Not Be a Barrier AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: Z. Lu: None.

Volume

25

Issue

8

First Page

S893

Last Page

S894

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