Outcomes of Renal Transplantation in Elderly Patients: Experience From Two Centers
Background
Elderly patients are the fastest growing age group in end-stage renal failure. Data from overseas show that transplantation is a safe and reliable mode of treatment for this group of patients. However, local data about the outcome in these patients are lacking. The aim of this study was to determine and compare the outcomes of renal transplantation among elderly recipients and younger recipients.
Methods
Using the Organ Registry and Transplant System in Kwong Wah Hospital and Princess Margaret Hospital, adult patients who had undergone renal transplantation and who had been followed-up by the two medical units were recruited. They were divided into the control group (age < 60) and the elderly group (age ≥ 60) according to age at transplantation. The following data were collected for cross-sectional analysis: comorbid illnesses, transplantation details, immunosuppressive therapy, incidence and severity of acute rejections, incidence of infection and malignancy, graft and patient survival, and causes of graft loss and death.
Results
A total of 324 episodes of transplantation were recorded (266 controls and 58 elderly). The incidence of acute rejection was higher in the control group (18% vs. 8.6%, p = 0.08). There was a trend towards higher incidence of infection and malignancy in the elderly group, though the difference did not reach statistical significance. The graft survival rate was similar in the two groups, while the 5-year patient survival rate was worse in the elderly group (92.1% vs. 79.3%, p = 0.0058).
Conclusion
The transplantation outcomes in elderly recipients are satisfactory, and age per se should not be considered a contraindication to transplantation.
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aDepartment of Medicine and Geriatrics, Our Lady of Maryknoll Hospital, Kowloon, Hong Kong SAR
bRenal Unit, Department of Medicine and Geriatrics, Kwong Wah Hospital, Kowloon, Hong Kong SAR
cDepartment of Medicine and Geriatrics, Princess Margaret Hospital, Kowloon, Hong Kong SAR
Correspondence to: Dr. Lo Man-Wai, Department of Medicine and Geriatrics, Our Lady of Maryknoll Hospital, 118 Shatin Pass Road, Wong Tai Sin, Kowloon, Hong Kong SAR. Fax: (+ 852) 23542221
ABSTRACT