Open AccessAccess to kidney transplantation in European adults aged 75–84 years and related outcomes: an analysis of the European Renal Association–European Dialysis and Transplant Association Registry
Author(s) -
Pippias Maria,
Stel Vianda S.,
Kramer Anneke,
Abad Diez Jose M.,
ArestéFosalba Nuria,
Ayav Carole,
Buturovic Jadranka,
Caskey Fergus J.,
Collart Frederic,
Couchoud Cécile,
De Meester Johan,
Heaf James G.,
Helanterä Ilkka,
Hemmelder Marc H.,
Kostopoulou Myrto,
Noordzij Marlies,
Pascual Julio,
Palsson Runolfur,
Reisæter Anna Varberg,
Traynor Jamie P.,
Massy Ziad,
Jager Kitty J.
Publication year - 2018
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13125
Subject(s) - medicine , dialysis , kidney transplantation , renal replacement therapy , transplantation , confidence interval , proportional hazards model , population , nephrology , intensive care medicine , demography , environmental health , sociology
Summary To what extent access to, and allocation of kidney transplants and survival outcomes in patients aged ≥75 years have changed over time in Europe is unclear. We included patients aged ≥75–84 years (termed older adults) receiving renal replacement therapy in thirteen European countries between 2005 and 2014. Country differences and time trends in access to, and allocation of kidney transplants were examined. Survival outcomes were determined by Cox regression analyses. Between 2005 and 2014, 1392 older adult patients received 1406 transplants. Access to kidney transplantation varied from ~0% (Slovenia, Greece and Denmark) to ~4% (Norway and various Spanish regions) of all older adult dialysis patients, and overall increased from 0.3% (2005) to 0.9% (2014). Allocation of kidney transplants to older adults overall increased from 0.8% (2005) to 3.2% (2014). Seven‐year unadjusted patient and graft survival probabilities were 49.1% (95% confidence interval, 95% CI : 43.6; 54.4) and 41.7% (95% CI : 36.5; 46.8), respectively, with a temporal trend towards improved survival outcomes. In conclusion, in the European dialysis population aged ≥75–84 years access to kidney transplantation is low, and allocation of kidney transplants remains a rare event. Though both are increasing with time and vary considerably between countries. The trend towards improved survival outcomes is encouraging. This information can aid informed decision‐making regarding treatment options.