Outcomes of Renal Transplantation in Older High Risk Recipients: Is There an Age Effect?

Background. The purpose of this study was to evaluate long-term outcomes in high risk renal transplant recipients over 60 years of age compared with those younger than 60 years of age. Materials and Methods. We analyzed outcomes in 131 consecutive renal transplant recipients at our institution between November 2001 and December 2007. Primary outcomes included incidence of delayed graft function (DGF), acute rejection, graft survival, patient survival, and incidence of infections and neoplasms. Results. Older recipients (Over 60 group, n = 45) received more organs from extended criteria donors (ECD) or donation after cardiac death donors (DCD) compared with younger recipients (Under 60 group, n = 86), 42% versus 17% respectively, P = 0.001. Multivariate analyses revealed that African American ethnicity and DCD donation had the greatest impact on the incidence of DGF in both groups; P < 0.05. Patient survival and graft survival beyond 1 y were similar between the two groups. Conclusion. Our data suggest that long-term transplant outcomes in older, high risk renal transplant recipients are similar to those of younger, high risk recipients. Older recipients' age and high-risk characteristics, such as African American ethnicity and increased sensitization, should not be a contraindication to renal transplantation in the elderly. (C) 2010 Elsevier Inc. All rights reserved.