Live and Deceased Donor Kidney Transplantation in Patients Aged 75 years and Older in the United States

Objective: To examine the outcomes of geriatric ESRD patients selected for kidney transplantation. Design: Data were extracted from the USRDS Standard Analysis Files (SAF). All persons ages 75 and over who received a kidney transplant from 1994 to 2000 were compared with those remaining on dialysis or on a transplant waiting list. Data on mortality or removal from the waiting list were obtained from the United Network for Organ Sharing (UNOS). The main outcome measure was patient and kidney transplant survival. Results: Superior five year survival after kidney transplantation was attained by the geriatric cohort given a live donor transplant (59.9%), compared with recipients of deceased donor kidneys (40.3%), dialysis patients waiting for transplant (29.7%), and those who were not selected for kidney transplantation and remained on dialysis (12.5%). The likelihood of being removed from the waiting list for any reason was higher in this group (over 75) (30.3%) than in the 66–75 age group (26.8%). Their average annual mortality rate on the waiting list was 7.9, compared to 6.6% for those 66–75. Conclusion: Even after the age of 75 years, kidney transplantation provides substantial life prolongation and excellent graft survival.