A National Cohort Validation of Graft Outcomes of Elderly Kidney Transplant Recipients
Bajjoka I, Yaldo A, Crombez C, and Abouljoud M. A National Cohort Validation of Graft Outcomes of Elderly Kidney Transplant Recipients. Am J Transplant 2019; 19:918.
Am J Transplant
Purpose: Previous analyses comparing elderly kidney transplant recipients (KTR) to younger KTR found that elderly patients suffered higher rates of mortality, less biopsy-proven acute rejection (BPAR), and similar graft survival. A national cohort of patients is presented to validate these results. As the number of elderly KTR increases, differences between this population and younger are unknown. Methods: A national retrospective analysis of records of 225021 from 2008-2017 was performed. The study population was divided into two cohorts: (Y:65 yrs; n=l 72942). KTR aged 60-64 were excluded to distinguish groups. Graft and patient survival were demonstrated by Kaplan-Meier plots and reliability was tested using a multivariate Cox proportional-hazards model and log-rank test. Rates of rejection at 6 months and 1 year post-transplant were compared and reliability was tested using the Chi-square test. The rate of antithymocyte globulin for induction therapy in each group was also collected. Results: Younger KTR were51 (46, 55)years oldandfollowedfor 1114(385, 2097) days. Elderly KTR were 68 (66, 71) years old and followed for 1063 (365, 1818) days. The overall survival probability is significantly higher in the younger group. The CoxPH models show the younger group has a hazard ratio of 0. 36 (p