Comparative survival of elderly renal transplant recipients with a living donor versus a deceased donor: A retrospective single center observational study

Erzsi Tegzess, Antonio W Gomes Neto, Robert A Pol, Silke E de Boer, Hessel Peters-Sengers, Jan-Stephan F Sanders, Stefan P Berger*

*Corresponding author for this work

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Abstract

Increasing numbers of elderly (>= 65 years) patients are listed for kidney transplantation. This study compares the survival outcome between living (LDK), regularly allocated (ETKAS), and Eurotransplant Senior Program (ESP) donor kidneys in elderly recipients. This is a single-center retrospective cohort study of elderly kidney transplant recipients transplanted between 2005 and 2017. Primary outcome measures were nondeath-censored graft, death-censored graft, and patient survival. In total, 348 patients were transplanted, 109 recipients (31.3%) received an LDK, 100 (28.7%) an ETKAS, and 139 (40%) an ESP kidney. 62.5% were male, and median age was 68 years. LDK recipients had significantly better 5-year nondeath-censored graft survival compared with ETKAS and ESP (resp. 71.0% vs. 66.1% vs. 55.6%, P = 0.047). Death-censored graft survival after 1 year was significantly better in LDK recipients (99.1%) (ETKAS 90.8%; ESP 87.7%, P < 0.001). After 5 years, the difference remained significant (P < 0.001) with little additional graft loss (97.7% vs. 88.1% vs. 85.6). There was no significant difference in patient survival after 5 years (71.7% vs. 67.4% vs 61.9%, P = 0.480). In elderly recipients, the patient survival benefits of an LDK are limited, but there is decreased death-censored graft loss for LDK recipients. Nevertheless, graft survival in ETKAS and ESP remains satisfactory.

Original languageEnglish
Pages (from-to)2746-2754
Number of pages9
JournalTransplant International
Volume34
Issue number12
Early online date28-Oct-2021
DOIs
Publication statusPublished - Dec-2021

Keywords

  • deceased donor
  • elderly patients
  • graft survival
  • kidney transplantation
  • living donor
  • patient survival
  • QUALITY-OF-LIFE
  • KIDNEY-TRANSPLANTATION
  • GRAFT-SURVIVAL
  • OLDER
  • HEMODIALYSIS
  • PATIENT
  • AGE

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