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Prognostic factors in kidney transplantation in the septuagenarian: a multicenter analysis
Author(s) -
SaucedoCrespo Hector,
Haakinson Danielle J.,
Croome Kristopher P.,
Mai Martin L.,
Taner C. Burcin,
Heilman Raymond L.,
Gonwa Thomas
Publication year - 2016
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12756
Subject(s) - medicine , hazard ratio , panel reactive antibody , body mass index , surgery , coronary artery disease , transplantation , confidence interval , kidney transplantation , kidney disease , proportional hazards model , cardiology
Kidney transplant ( KT ) programs have extended recipient eligibility to those who were previously excluded due to advanced age. We aimed to determine the outcomes of the patients ≥70 years undergoing KT and investigate factors predicting survival. Two thousand six hundred and twenty‐four KT patients between 2003 and 2013 at two institutions were divided into two groups; those ≥70 years (n=300) and those <70 years (n=2324) at the time of KT . Patient survival at 1, 3, and 5 years was 95%, 86%, and 77% in ≥70 years of age group and 98%, 95%, and 90% in the <70 years group ( P <.001). When graft loss due to death was censored, graft survival was not significantly different between the two groups ( P =.18). On multivariable analysis, the significant predictors of inferior survival in patients ≥70 years included: body mass index ( BMI )>30 kg/m 2 (hazard ratio [ HR ] 1.07; P =.01), panel reactive antibody ( PRA )>20% ( HR 2.38; P =.01), previous coronary artery bypass grafting ( CABG ; HR 1.95; P =.03) and peripheral vascular disease ( PVD ; HR 2.60; P =.04). Acceptable outcomes can be achieved in KT recipients ≥70 years. Caution should be used when listing these patients if they have BMI >30 kg/m 2 , PRA >20%, CABG or PVD .