Is it Better Choice to Perform Kidney Transplantation for Elderly CKD Patients?

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ObjectivesJapan is forecasted to become an aged society with 30.3% and 39.9% in 2025 and 2060, respectively. Along with that, the number of elderly patients who have to start renal replacement therapy and elderly candidates who wish to receive kidney transplantation will increase every year. In united states renal data system, it was reported that the average life expectancy of transplant patients was increased comparing to dialysis patients regardless of the age receiving transplantation. We examined the safety and efficacy of kidney transplantation for aged recipients, retrospectively.Materials and MethodsWe examined demographics, the incidence of peri- and post-surgical complications, post-transplant hypertension, infection, acute graft rejection, mean serum creatinine level, and patient and graft survival rates, respectively. In addition, we investigated the patient survival and graft survival rates about elderly (60 years old and over) kidney transplant recipients in Osaka University Transplantation Group.ResultsFrom March 1965 to December 2016, 1953 recipients received kidney transplantation. All of them, 131 cases were classified into elderly group, and 46 cases were 65years old and over (85 cases sere 60-64 yeas old). The majority received their grafts from unrelated donors (generally from their spouses). There was not significantly different between elderly recipient and others who was 59years old and younger in graft survival rate (Log-rank test, p=0.3669). On the other hand, in patient survival rate, there was not significantly different between elderly recipient and others who was 59years old and younger (Log-rank test, p=0.0686). Ten years survival rates of the recipients were 83.3% (>64 years old), 89.1% (60-64 years old), 95.2% (<60 years old).ConclusionThere was not any severe adverse events at the peri and post kidney transplantations. It was reported that 10 years survival rate of the patients who is on hemodialysis is 35.9%. Patient survival rate of the kidney transplant recipients was excellent regardless of their age.

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