Renal transplantation in the elderly

South Indian experience

Asik Ali Mohamed Ali, Georgi Abraham, Pallavi Khanna, Yogesh N.V. Reddy, Anurag Mehrotra, Milly Mathew, Saravanan Sundararaj, Riswana Jasmine

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

In developing countries, renal transplantation is offered to young end-stage renal disease (ESRD) patients, while the older ones face limitations due to higher mortality risk. We retrospectively analyzed 225 patients who underwent renal transplantation from living donors, aged 40-60 years (Group A) and >60 years (Group B), focusing on their survival outcome. Group A (n = 181) had mean creatinine (mg/dL) 1.41 ± 0.84, 1.30 ± 0.65 and 1.40 ± 0.60 and mean eGFR (mL/min/1.73 m 2 ) of 65.32 ± 23.03, 69.14 ± 32.65 and 59.21 ± 22.79 at 0, 3 and 6 months post-transplantation. Death-censored graft survival was 93.1% in first year followed by 91.2% in subsequent 4 years. Patient survival was 92.5% in first year, 90.7% in the next 2 years, and 89.2% in 4th year. Highest cumulative graft survival was 86.7% in the first year with 83.4%, 82.7% and 82.4% during the subsequent 3 years. Group B (n = 44) had mean creatinine (mg/dL) of 1.46 ± 1.02, 1.29 ± 0.23 and 1.2 ± 0.29 with a mean eGFR (mL/min/1.73 m 2 ) of 67.90 ± 23.48, 67.02 ± 12.76 and 75.23 ± 15.19 at 0, 3 and 6 months. Highest death-censored graft survival was 97.4% in the first year with 94.7% in next 3 years. Patient survival was 88.1% throughout 4 years post-transplantation. Cumulative graft survival was 84.1% during 4 years. Biopsy-proven acute rejection rate was 28.7% in group A and 15.9% in group B (P = 0.058). There was higher mortality rate in group B with death mainly due to infections and cardiovascular complication. Cardiovascular risk assessment, pre-transplant cancer screening and judicious use of immunosuppressive agents should help minimize adverse events, balanced with an inherently reduced risk of acute rejection, hence the graft survival advantage and is the way forward to maximize patient and renal allograft survival in elderly patients.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalInternational Urology and Nephrology
Volume43
Issue number1
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

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Kidney Transplantation
Graft Survival
Survival
Creatinine
Cardiovascular Infections
Transplantation
Mortality
Living Donors
Immunosuppressive Agents
Early Detection of Cancer
Developing Countries
Chronic Kidney Failure
Allografts
Transplants
Kidney
Biopsy

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Urology

Cite this

Mohamed Ali, A. A., Abraham, G., Khanna, P., Reddy, Y. N. V., Mehrotra, A., Mathew, M., ... Jasmine, R. (2011). Renal transplantation in the elderly: South Indian experience. International Urology and Nephrology, 43(1), 265-271. https://doi.org/10.1007/s11255-010-9887-4

Renal transplantation in the elderly : South Indian experience. / Mohamed Ali, Asik Ali; Abraham, Georgi; Khanna, Pallavi; Reddy, Yogesh N.V.; Mehrotra, Anurag; Mathew, Milly; Sundararaj, Saravanan; Jasmine, Riswana.

In: International Urology and Nephrology, Vol. 43, No. 1, 01.03.2011, p. 265-271.

Research output: Contribution to journalArticle

Mohamed Ali, AA, Abraham, G, Khanna, P, Reddy, YNV, Mehrotra, A, Mathew, M, Sundararaj, S & Jasmine, R 2011, 'Renal transplantation in the elderly: South Indian experience', International Urology and Nephrology, vol. 43, no. 1, pp. 265-271. https://doi.org/10.1007/s11255-010-9887-4
Mohamed Ali, Asik Ali ; Abraham, Georgi ; Khanna, Pallavi ; Reddy, Yogesh N.V. ; Mehrotra, Anurag ; Mathew, Milly ; Sundararaj, Saravanan ; Jasmine, Riswana. / Renal transplantation in the elderly : South Indian experience. In: International Urology and Nephrology. 2011 ; Vol. 43, No. 1. pp. 265-271.
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N2 - In developing countries, renal transplantation is offered to young end-stage renal disease (ESRD) patients, while the older ones face limitations due to higher mortality risk. We retrospectively analyzed 225 patients who underwent renal transplantation from living donors, aged 40-60 years (Group A) and >60 years (Group B), focusing on their survival outcome. Group A (n = 181) had mean creatinine (mg/dL) 1.41 ± 0.84, 1.30 ± 0.65 and 1.40 ± 0.60 and mean eGFR (mL/min/1.73 m 2 ) of 65.32 ± 23.03, 69.14 ± 32.65 and 59.21 ± 22.79 at 0, 3 and 6 months post-transplantation. Death-censored graft survival was 93.1% in first year followed by 91.2% in subsequent 4 years. Patient survival was 92.5% in first year, 90.7% in the next 2 years, and 89.2% in 4th year. Highest cumulative graft survival was 86.7% in the first year with 83.4%, 82.7% and 82.4% during the subsequent 3 years. Group B (n = 44) had mean creatinine (mg/dL) of 1.46 ± 1.02, 1.29 ± 0.23 and 1.2 ± 0.29 with a mean eGFR (mL/min/1.73 m 2 ) of 67.90 ± 23.48, 67.02 ± 12.76 and 75.23 ± 15.19 at 0, 3 and 6 months. Highest death-censored graft survival was 97.4% in the first year with 94.7% in next 3 years. Patient survival was 88.1% throughout 4 years post-transplantation. Cumulative graft survival was 84.1% during 4 years. Biopsy-proven acute rejection rate was 28.7% in group A and 15.9% in group B (P = 0.058). There was higher mortality rate in group B with death mainly due to infections and cardiovascular complication. Cardiovascular risk assessment, pre-transplant cancer screening and judicious use of immunosuppressive agents should help minimize adverse events, balanced with an inherently reduced risk of acute rejection, hence the graft survival advantage and is the way forward to maximize patient and renal allograft survival in elderly patients.

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