The risk of chronic kidney disease increases with age. The number of elderly patients with end-stage renal disease (ESRD) is growing, and patients with ESRD require kidney transplantation. In a recent study, a team of researchers from several medical centers and universities in Uruguay and Spain found that elderly patients still benefit from kidney transplantation, even when the organ is from an older donor.*

What they did

The outcomes of kidney transplantation (KT) were investigated in 138 patients aged 75 years and older. The study reviewed elderly patients who received a kidney transplant between 2002 and 2015 from a deceased donor of a similar age. 

What they found

• Post-transplant survival was “excellent,” with 82.1% of elderly patients with KT still with life after one year and 60.1% of patients still with life after five years.
• Survival rates after adjusting for successful transplantation (i.e., death from causes other than graft failure) were 95.6% one year after KT and 93.1% after five years.
• Infection reduced one-year survival while diabetic nephropathy impacted five-year survival.
• Almost all patients remained dialysis-free for the rest of their lives.

In a news article by the European Renal Association—European Dialysis and Transplant Association (ERA-EDTA), Press Officer Ron Gansevoort explained the benefits of kidney transplantation, ”We know that patients benefit immensely from this treatment; survival and quality of life are significantly better compared to dialysis patients.” 

What this means

• The point of view that KT should not be offered to very elderly people (75 years of age and older) with ESRD because of a presumed higher level of risk may need to be reconsidered.
• Kidneys from deceased elderly donors may be able to be used for KT in elderly patients. 

Conclusion

While the results are promising, Professor Gansevoort noted that ”larger studies that also take quality of life, number of hospital admissions, and duration of hospital stays into account are also needed.” 

*Cabrera, J.; Fernández-Ruiz, M.; Trujillo, H.; et al. (2020, Feb. 12). “Kidney transplantation in the extremely elderly from extremely aged deceased donors: a kidney for each age.” Nephrology Dialysis Transplantation.