RENAL-TRANSPLANTATION FOR PATIENTS 60 YEARS OF AGE OR OLDER - A SINGLE-INSTITUTION EXPERIENCE

Objective The authors reviewed renal transplant outcomes in recipients 60 years of age or older. Background Before cyclosporine, patients ol der than 45 years of age were considered to be al high risk for transp lantation. With cyclosporine, the age limits for transplantation have expanded. Methods The authors compared patient and graft survival, hos pital stay, the incidence of rejection and rehospitalization, and the cause of graft loss for primary kidney recipients 60 years of age or o lder versus those 18 to 59 years of age. For those patients greater th an or equal to 60 years transplanted since 1985, the authors analyzed pretransplant extrarenal disease and its impact on post-transplant out come. In addition, all surviving recipients greater than or equal to 6 0 years completed a medical outcome survey (SF-36). Results Patient an d graft survival for those greater than or equal to 60 years of age ve rsus those 18 to 59 years of age were similar 3 years after transplant . Subsequently, mortality increased for the older recipients. Death-ce nsored graft survival was identical in the two groups. There were no d ifferences in the cause of graft loss. Those 60 years of age or older had a longer initial hospitalization, but had fewer rejection episodes and fewer rehospitalizations. Quality of life for recipients 60 years of age or older was similar to the age-matched U.S. population. Concl usion Renal transplantation is successful for recipients 60 years of a ge or older. Most of them had extrarenal disease at the time of transp lantation; however, extrarenal disease was not an important predictor of outcome and should not be used as an exclusion criterion. Post-tran splant quality of life is excellent.