Single Center Experience with Deceased Donor Kidney Transplantation in Patients Aged 70 and Older: A Matched-Pair Cohort Study
Umar Farooq1, Yousef Al-Shraideh1, Ravi Katari, BS1, Alan C. Farney1, Jeffrey Rogers1, Giuseppe Orlando1, Michael D. Gautreaux1, Gloria Hairston1, Margaret Mangus1, Elizabeth Brim1, Robert J. Stratta1*, Amudha Palanisamy2, Amber Reeves-Daniel2, William Doares3, Scott Kaczmorski3 and Samy S. Iskandar4
1Departments of General Surgery, Wake Forest School of Medicine, USA
2Departments of Internal Medicine, Wake Forest School of Medicine, USA
3Departments of Pharmacy, Wake Forest School of Medicine, USA
4Departments of Pathology, Wake Forest School of Medicine, USA
- *Corresponding Author:
- Robert J Stratta
Director of Transplantation
Wake Forest School of Medicine
General Surgery, Medical Center Blvd
Winston-Salem, NC 27157, USA
E-mail: [email protected]
Received Date: July 01, 2014; Accepted Date: September 08, 2014; Published Date: September 10, 2014
Citation: Farooq U, Al-Shraideh Y, Katari R, Farney AC, Rogers J, et al. (2014) Single Center Experience with Deceased Donor Kidney Transplantation in Patients Aged 70 and Older: A Matched-Pair Cohort Study. J Transplant Technol Res 4: 135. doi: 10.4172/2161-0991.1000135
Copyright: © 2014 Farooq U, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Aim:The purpose of this study was to compare mate deceased donor (DD) kidney transplant (KT) outcomes in patients ≥70 versus <70 years of age in a matched-pair analysis.
Methods: Single center retrospective review of adult KT cases.
Results: From 5/03 to 3/12, we identified 33 DD kidney pairs that met the above criteria. Mean donor age and BMI were 52 years and 27.4 kg/m2, respectively, including 19 (58%) expanded criteria donors. Mean recipient ages were 73.6 and 55.3 years in the 2 groups (p<0.01). No significant differences were noted in multiple recipient and transplant characteristics in the older and younger groups. With a mean follow-up of 58 months, actual patient (79% older versus 94% younger, p=0.15) and kidney graft survival ([KGS] 64% older versus 67% younger) rates were comparable. Two-year patient (97% older versus 94% younger) and KGS (91% older versus 82% younger) rates revealed few early deaths or graft losses in the older group. Death-censored KGS (81% older versus 69% younger) rates demonstrated that the older group had more deaths with functioning grafts (DWFG, 21% versus 3%, p=0.05). Mean length of initial hospital stay, renal function, and rates of delayed graft function, acute rejection, major infection, re-operations and readmissions were comparable. In 13 patients aged 75 years and older, the incidence of DWFG was 31% in patients compared to 15% in patients aged 70-74 (p=0.33 compared to those >75), and 3% in all 33 younger patients (p=0.02 compared to those >75). The timing of DWFG was at a mean of 40.5 months in patients aged 75 and older compared to 72 months for those aged 70-74 years.
Conclusions: When controlling for donor factors in a paired kidney analysis, medium-term outcomes are largely influenced by a higher incidence of DWFGs in the elderly, particularly in patients aged 75 and older.