Access to kidney transplantation in European adults aged 75–84 years and related outcomes: an analysis of the European Renal Association–European Dialysis and Transplant Association Registry |
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| Authors: | Maria Pippias Vianda S. Stel Anneke Kramer Jose M. Abad Diez Nuria Aresté‐Fosalba Carole Ayav Jadranka Buturovic Fergus J. Caskey Frederic Collart Cécile Couchoud Johan De Meester James G. Heaf Ilkka Helanterä Marc H. Hemmelder Myrto Kostopoulou Marlies Noordzij Julio Pascual Runolfur Palsson Anna Varberg Reisæter Jamie P. Traynor Ziad Massy Kitty J. Jager |
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| Affiliation: | 1. ERA‐EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands;2. Servicio Aragonés de la Salud, Gobierno de Aragón, Zaragoza, Spain;3. Department of Nephrology, University Hospital Virgen Macarena, Seville, Spain;4. Inserm, CIC 1433 Clinical Epidemiology, CHRU de Nancy, Nancy, France;5. Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia;6. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia;7. UK Renal Registry, Southmead Hospital, Bristol, UK;8. Population Health Sciences, University of Bristol, Bristol, UK;9. French‐Belgian ESRD Registry, Brussels, Belgium;10. REIN Registry, Agence de la Biomédecine, Saint‐Denis La Plaine, France;11. Department of Nephrology, Dialysis and Hypertension, Dutch‐speaking Belgian Renal Registry (NBVN), Sint‐Niklaas, Belgium;12. Department of Medicine, Zealand University Hospital, Roskilde, Denmark;13. Transplantation and Liver Surgery, Helsinki University Hospital, Helsinki, Finland;14. Dutch Renal Replacement Registry (RENINE), Nefrovisie Foundation, Utrecht, The Netherlands;15. Department of Nephrology, General Hospital “G. Gennimatas”, Athens, Greece;16. Department of Nephrology, Hospital del Mar, Barcelona, Spain;17. Division of Nephrology, Landspitali – The National University Hospital of Iceland, Reykjavik, Iceland;18. Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland;19. Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Norway;20. Scottish Renal Registry, Meridian Court, ISD Scotland, Glasgow, UK;21. Division of Nephrology, Ambroise Paré University Hospital, APHP, University of Paris Ouest‐Versailles‐St‐Quentin‐en‐Yvelines (UVSQ), Boulogne‐Billancourt/Paris, France;22. Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Team 5, CESP UVSQ, University Paris Saclay, Villejuif, France |
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| Abstract: | To what extent access to, and allocation of kidney transplants and survival outcomes in patients aged ≥75 years have changed over time in Europe is unclear. We included patients aged ≥75–84 years (termed older adults) receiving renal replacement therapy in thirteen European countries between 2005 and 2014. Country differences and time trends in access to, and allocation of kidney transplants were examined. Survival outcomes were determined by Cox regression analyses. Between 2005 and 2014, 1392 older adult patients received 1406 transplants. Access to kidney transplantation varied from ~0% (Slovenia, Greece and Denmark) to ~4% (Norway and various Spanish regions) of all older adult dialysis patients, and overall increased from 0.3% (2005) to 0.9% (2014). Allocation of kidney transplants to older adults overall increased from 0.8% (2005) to 3.2% (2014). Seven‐year unadjusted patient and graft survival probabilities were 49.1% (95% confidence interval, 95% CI: 43.6; 54.4) and 41.7% (95% CI: 36.5; 46.8), respectively, with a temporal trend towards improved survival outcomes. In conclusion, in the European dialysis population aged ≥75–84 years access to kidney transplantation is low, and allocation of kidney transplants remains a rare event. Though both are increasing with time and vary considerably between countries. The trend towards improved survival outcomes is encouraging. This information can aid informed decision‐making regarding treatment options. |
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| Keywords: | elderly epidemiology Europe graft survival kidney transplantation |
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