Survival Benefit From Kidney Transplantation Using Kidneys From Deceased Donors Aged ≥75 Years: A Time‐Dependent Analysis |
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| Authors: | M. J. Pérez‐Sáez E. Arcos J. Comas M. Crespo J. Lloveras J. Pascual the Catalan Renal Registry Committee |
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| Affiliation: | 1. Department of Nephrology, Hospital del Mar, Barcelona, Spain;2. Institut Mar d'Investigacions Médiques, Barcelona, Spain;3. Organització Catalana de Trasplantaments, Barcelona, Spain |
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| Abstract: | Patients with end‐stage renal disease have longer survival after kidney transplantation than they would by remaining on dialysis; however, outcome with kidneys from donors aged ≥75 years and the survival of recipients of these organs compared with their dialysis counterparts with the same probability of obtaining an organ is unknown. In a longitudinal mortality study, 2040 patients on dialysis were placed on a waiting list, and 389 of them received a first transplant from a deceased donor aged ≥75 years. The adjusted risk of death and survival were calculated by non–proportional hazards analysis with being transplanted as a time‐dependent effect. Projected years of life since placement on the waiting list was almost twofold higher for transplanted patients. Nonproportional adjusted risk of death after transplantation was 0.44 (95% confidence interval [CI] 0.61–0.32; p < 0.001) in comparison with those that remained on dialysis. Stratifying by age, adjusted hazard ratios for death were 0.17 (95% CI 0.47–0.06; p = 0.001) for those aged <65 years, 0.56 (95% CI 0.92–0.34; p = 0.022) for those aged 65–69 years and 0.82 (95% CI 1.28–0.52; p = 0.389) for those aged ≥70 years. Although kidney transplantation from elderly deceased donors is associated with reduced graft survival, transplanted patients have lower mortality than those remaining on dialysis. |
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| Keywords: | clinical research/practice kidney transplantation/nephrology organ procurement and allocation donors and donation donors and donation: donor evaluation organ acceptance |
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