Renal transplantation in the elderly: a long-term, single-centre experience

Background. End-stage renal failure increases with advancing age and renal transplantation should be considered in end-stage renal failure patients ol der than 60 years. However, there is a paucity of data on long-term patient and graft survival in this population. Methods. From October 1983 to March 1999, 310 renal transplantations were p erformed at Geneva University Hospital in 283 patients, of which 49 were do ne in 48 patients older than 60 years (mean age 65.6 +/- 4.1 years). The fo llowing data were analysed at 1, 5, and 10 years, and compared between the patients > 60 years and < 60 years old: actuarial patient and graft surviva l, serum creatinine, causes of graft loss, and patient death. Results. Patient survival at 10 years was 81% for patients < 60 years and 4 4% for patients > 60 years. Graft survival at 10 years was 59% for patients < 60 years and 32% for patients > 60 years. Graft survival at 10 years cen sored for death with functioning graft was 65% for patients (60 years and 8 1% for patients > 60 years. Main causes of mortality ill the older patients were related to cardiovascular events (47%), neoplasia (41%), and sepsis ( 18%). Overall, recipient and donor age were not predictive factors for graf t survival, as shown by multiple logistic regression. Conclusions. Renal transplantation should be considered in patients older t han 60 years, since graft survival is excellent in this population. Althoug h these patients have a shorter life expectancy, they benefit from renal tr ansplantation similarly to younger kidney transplant recipients.