Impact of kidney transplant morbidity on elderly recipients' outcomes
- 1 March 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Aging Clinical and Experimental Research
- Vol. 33 (3), 625-633
- https://doi.org/10.1007/s40520-020-01558-4
Abstract
Background and aims Nowadays, advanced age does not represent an absolute contraindication to kidney transplantation (KT). However, aging is frequently associated with multiple comorbidities and lower performance status, making KT candidates less surgically fit. Limited data are available on the impact of KT morbidity on elderly recipients' outcomes. Methods Retrospective study on a single center cohort of 130 KT recipients over 65 years old, representing 16.2% of KT clinical series, during the period 2000-2018. Number and severity of comorbidities were evaluated with the Charlson Comorbidity index (CCI). Results The median age at transplantation was 67 [IQR66-71] years and median CCI was 5 [IQR4-6]. The prevalence of postoperative complications with a Clavien-Dindo (C-D) severity score > 2 was 29%. Increasing age did not predict KT morbidity in terms of C-D score > 2, infectious, respiratory, cardiologic, urologic or vascular complications, delayed graft function, symptomatic lymphocele, bleeding, acute or chronic rejection. Conversely, CCI score was a predictor of overall complications with C-D score > 2, cardiologic, respiratory and vascular complications, and bleeding. Among others, CCI score, post-KT cardiologic complications, C-D score > 2 were identified as significant predictors of both early mortality and graft loss in univariate analysis. Increasing recipient age did not correlate with graft loss risk and graft loss did not impact patient survival. C-D score > 2 was a predictor of poor survival even in multivariate analysis. Conclusions Elderly recipients showed a significant vulnerability to KT morbidity which correlates with CCI. While graft loss did not impact recipient survival, severe postoperative complications (C-D > 2) were independently associated increased mortality.Keywords
This publication has 20 references indexed in Scilit:
- Frailty and Sarcopenia in Older Patients Receiving Kidney TransplantationFrontiers in Nutrition, 2019
- Kidney Transplantation in Old Recipients From Old Donors: A Single-Center ExperienceTransplantation Proceedings, 2019
- Older kidney transplantation candidates’ expectations of improvement in life and health following kidney transplantation: semistructured interviews with enlisted dialysis patients aged 65 years and olderBMJ Open, 2018
- Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal DiseaseTransplantation, 2016
- Renal transplantation in the elderlyTransplantation Reviews, 2015
- Recipient-Related Risk Factors for Graft Failure and Death in Elderly Kidney Transplant RecipientsPLOS ONE, 2014
- Renal transplantation in elderly patients. How to select the candidates to the waiting list?Transplantation Reviews, 2014
- Survival of Renal Transplantation Patients Older Than 60 Years: A Single-Center ExperienceTransplantation Proceedings, 2013
- Recipient and donor risk factors for surgical complications following kidney transplantationScandinavian Journal of Urology, 2012
- Clinical Characteristics and Outcomes of Renal Transplantation in Elderly RecipientsTransplantation Proceedings, 2012