B DOUCET1,2, S CAMPBELL1, Y CHO1, N ISBEL1,3
1Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia, 2School of Medicine, University of Queensland, Brisbane, Australia, 3University of Queensland at the Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
Aim: To describe renal transplant outcomes of recipients ≥70 years old across Australia and New Zealand.
Background: Literature to date suggests kidney transplant in elderly recipients provides a survival benefit compared to continuing dialysis. Outcomes for transplant recipients ≥70 years in Australia and New Zealand have not been previously described. A descriptive study of kidney transplantation in elderly recipients using the ANZDATA registry was conducted.
Methods: All first graft transplant recipients from 2000-2015 registered in the ANZDATA registry were included in the study. Recipient characteristics relating to demographics, co-morbidities, graft outcomes and patient survival as well as donor-related characteristics were obtained. Transplant recipients were divided into two groups according to their age at the time of transplant (18-69years vs. ≥ 70years). Baseline characteristics and outcomes were compared using descriptive statistics and Cox proportional hazards models. P value <0.05 was considered statistically significant.
Results: Amongst the 10,651 kidney transplant recipients, 279 were elderly. Elderly recipients were more likely to have ischaemic heart disease (p<0.001), cerebrovascular disease (p<0.001), peripheral vascular disease(p=0.003), lung disease (p=0.02) and diabetes(p=0.007). Across the study period fewer elderly recipients developed rejection (19.4% vs 27.9%, p=0.002), with less rejection observed 3 months post-transplant (12.5% vs 18.0%, p=0.02). There was no difference in death censored time to graft failure (p=0.58). Across the study period, significantly more elderly recipients died (28.7% vs 13.7%, p<0.001) substantially more with functioning grafts (74.4% vs 43.2%, p<0.001).
Conclusions: Elderly patients received 2.6% of renal transplants with the majority of those occurring between 2011 to 2015. They experienced less rejection with similar graft survival compared to non-elderly recipients. Elderly recipients were more likely to die with functioning grafts.
Brian Doucet is a second year Nephrology Advanced Trainee from Queensland. He has previously presented at the ANZSN ASM in 2014 and 2017.