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Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation?
BACKGROUND: Elderly patients are the fastest-growing group in need of renal transplantation. This study puts focus on renal transplant recipients in their 80th year or longer at time of engraftment. Is there evidence to support an absolute upper age limit for renal transplantation? METHODS: Recipien...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120766/ https://www.ncbi.nlm.nih.gov/pubmed/27861296 http://dx.doi.org/10.1097/TP.0000000000001363 |
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author | Lønning, Kjersti Midtvedt, Karsten Leivestad, Torbjørn Reisæter, Anna V. Line, Pål-Dag Hartmann, Anders Heldal, Kristian |
author_facet | Lønning, Kjersti Midtvedt, Karsten Leivestad, Torbjørn Reisæter, Anna V. Line, Pål-Dag Hartmann, Anders Heldal, Kristian |
author_sort | Lønning, Kjersti |
collection | PubMed |
description | BACKGROUND: Elderly patients are the fastest-growing group in need of renal transplantation. This study puts focus on renal transplant recipients in their 80th year or longer at time of engraftment. Is there evidence to support an absolute upper age limit for renal transplantation? METHODS: Recipients in their 80th year or longer, transplanted between 1983 and 2015, were included. Data were retrieved from the Norwegian Renal Registry in the end of October 2015. Graft and patient survivals were compared with recipients aged 70 to 79 years at transplantation. RESULTS: Forty-seven patients older than 79 years were transplanted in the defined period. Median age 80.1 years, 81% were men. Median time on dialysis before transplantation was 18.5 months. All patients received an allograft from a deceased donor (median donor age, 61.8 years). In the death-censored graft survival model, there was no statistical difference between the groups. We found improved patient and graft survivals after introduction of mycophenolate mofetil and induction with basiliximab. Patients transplanted before 2000 had increased risk of death compared with those transplanted after 2000 (hazard ratio, 3.2; 95% confidence interval, 1.2-8.7). Median uncensored graft survival for patients transplanted after the year 2000 was 5.0 year (95% confidence interval, 2.4-7.6). Median patient survival was 5.0 years (3.1-6.9) and 5-year patient survival was 55%. CONCLUSIONS: Age by itself should not be an absolute contraindication against renal transplantation. An estimated 5-year survival rate of 55% post-engraftment for an 80-year-old patient is in our opinion more than acceptable. |
format | Online Article Text |
id | pubmed-5120766 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-51207662016-12-05 Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation? Lønning, Kjersti Midtvedt, Karsten Leivestad, Torbjørn Reisæter, Anna V. Line, Pål-Dag Hartmann, Anders Heldal, Kristian Transplantation Original Clinical Science—General BACKGROUND: Elderly patients are the fastest-growing group in need of renal transplantation. This study puts focus on renal transplant recipients in their 80th year or longer at time of engraftment. Is there evidence to support an absolute upper age limit for renal transplantation? METHODS: Recipients in their 80th year or longer, transplanted between 1983 and 2015, were included. Data were retrieved from the Norwegian Renal Registry in the end of October 2015. Graft and patient survivals were compared with recipients aged 70 to 79 years at transplantation. RESULTS: Forty-seven patients older than 79 years were transplanted in the defined period. Median age 80.1 years, 81% were men. Median time on dialysis before transplantation was 18.5 months. All patients received an allograft from a deceased donor (median donor age, 61.8 years). In the death-censored graft survival model, there was no statistical difference between the groups. We found improved patient and graft survivals after introduction of mycophenolate mofetil and induction with basiliximab. Patients transplanted before 2000 had increased risk of death compared with those transplanted after 2000 (hazard ratio, 3.2; 95% confidence interval, 1.2-8.7). Median uncensored graft survival for patients transplanted after the year 2000 was 5.0 year (95% confidence interval, 2.4-7.6). Median patient survival was 5.0 years (3.1-6.9) and 5-year patient survival was 55%. CONCLUSIONS: Age by itself should not be an absolute contraindication against renal transplantation. An estimated 5-year survival rate of 55% post-engraftment for an 80-year-old patient is in our opinion more than acceptable. Lippincott Williams & Wilkins 2016-12 2016-07-28 /pmc/articles/PMC5120766/ /pubmed/27861296 http://dx.doi.org/10.1097/TP.0000000000001363 Text en Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. |
spellingShingle | Original Clinical Science—General Lønning, Kjersti Midtvedt, Karsten Leivestad, Torbjørn Reisæter, Anna V. Line, Pål-Dag Hartmann, Anders Heldal, Kristian Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation? |
title | Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation? |
title_full | Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation? |
title_fullStr | Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation? |
title_full_unstemmed | Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation? |
title_short | Are Octogenarians With End-Stage Renal Disease Candidates for Renal Transplantation? |
title_sort | are octogenarians with end-stage renal disease candidates for renal transplantation? |
topic | Original Clinical Science—General |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120766/ https://www.ncbi.nlm.nih.gov/pubmed/27861296 http://dx.doi.org/10.1097/TP.0000000000001363 |
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