Clinical nephrology · 2026
Association of recipient age with deceased donor kidney transplant outcomes in a single-center cohort.
СтатьяНазвание и аннотация: Перевод в очереди
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Schindler Paul E, Patel Dave B, Ylagan Camille R, Bregman Adam P, Mandelbrot Didier, Astor Brad C, Parajuli Sandesh
Аннотация
INTRODUCTION: As the number of elderly patients with end-stage kidney disease (ESKD) increases, the importance of understanding how age affects post-transplant success grows. We sought to quantify the association of age with key outcomes in deceased donor kidney transplant (DDKT) recipients.
MATERIALS AND METHODS: We did a single-center retrospective cohort analysis of all DDKT recipients who received kidneys between January 2001 and June 2021, stratified by age into 4 groups (18 - 49, 50 - 59, 60 - 69, ≥ 70). Outcomes of interest included uncensored graft failure (UCGF), death-censored graft failure (DCGF), and death with a functioning graft (DWFG) within 5 years of transplant and acute rejection (AR) within 1 year of transplant.
RESULTS: Of 3,119 recipients, 1,192 (38.2%) were 18 - 49 years old (reference group), 947 (30.4%) were 50 - 59, 795 (25.5%) were 60 - 69, and 185 (5.9%) were ≥ 70. The adjusted hazard ratio (aHR) for UCGF was 1.22 (95% CI: 1.01 - 1.48) for 50 - 59 years; 1.78 (95% CI: 1.47 - 2.17) for 60 - 69; and 2.83 (95% CI: 2.13 - 3.76) for ≥ 70. The aHR for DCGF was only statistically significant for the ≥ 70 age group at 1.73 (95% CI: 1.16 - 2.96). The aHR for DWFG was 2.00 (95% CI: 1.47 - 2.73) for 50 - 59 years; 3.36 (95% CI: 2.47 - 4.58) for 60 - 69; and 5.45 (95% CI: 3.95 - 8.26) for ≥ 70. The aHR for AR was 0.73 (95% CI: 0.61 - 0.88) for 50 - 59 years; 0.69 (95% CI: 0.56 - 0.84) for 60 - 69; and 0.47 (95% CI: 0.31 - 0.72) for ≥ 70.
CONCLUSION: DDKT recipients over the age of 70 are at a higher risk of UCGF, DCGF, and DWFG but have a lower risk of AR than their younger counterparts.
MATERIALS AND METHODS: We did a single-center retrospective cohort analysis of all DDKT recipients who received kidneys between January 2001 and June 2021, stratified by age into 4 groups (18 - 49, 50 - 59, 60 - 69, ≥ 70). Outcomes of interest included uncensored graft failure (UCGF), death-censored graft failure (DCGF), and death with a functioning graft (DWFG) within 5 years of transplant and acute rejection (AR) within 1 year of transplant.
RESULTS: Of 3,119 recipients, 1,192 (38.2%) were 18 - 49 years old (reference group), 947 (30.4%) were 50 - 59, 795 (25.5%) were 60 - 69, and 185 (5.9%) were ≥ 70. The adjusted hazard ratio (aHR) for UCGF was 1.22 (95% CI: 1.01 - 1.48) for 50 - 59 years; 1.78 (95% CI: 1.47 - 2.17) for 60 - 69; and 2.83 (95% CI: 2.13 - 3.76) for ≥ 70. The aHR for DCGF was only statistically significant for the ≥ 70 age group at 1.73 (95% CI: 1.16 - 2.96). The aHR for DWFG was 2.00 (95% CI: 1.47 - 2.73) for 50 - 59 years; 3.36 (95% CI: 2.47 - 4.58) for 60 - 69; and 5.45 (95% CI: 3.95 - 8.26) for ≥ 70. The aHR for AR was 0.73 (95% CI: 0.61 - 0.88) for 50 - 59 years; 0.69 (95% CI: 0.56 - 0.84) for 60 - 69; and 0.47 (95% CI: 0.31 - 0.72) for ≥ 70.
CONCLUSION: DDKT recipients over the age of 70 are at a higher risk of UCGF, DCGF, and DWFG but have a lower risk of AR than their younger counterparts.