Renal transplantation is increasingly being carried out in older patients, with generally acceptable results. Because we have an increasingly aging population, we retrospectively reviewed the results of renal transplantation in patients over 60 years of age at our center. A retrospective study was conducted of 212 Bahraini patients receiving renal transplants from January 1979 to December 2007. All medical records were reviewed for demographic data, graft function and survival. Patient and graft survival was compared for patients above and below the age of 60. Seventeen patients >60 years with a mean age of 64.1±3.6 years at the time of transplantation. Sex: 76.5% Males. Diabetic nephropathy (52%) and PCKD (12%) were the most common causes of ESRD. Mean donor age was 26±6 years and most of them were unrelated (82%). Follow-up was until death or until 1/3/2008. Of the 17 study patients, 4 died: 3 with a functioning graft, 1 within one year of transplantation. Cardiovascular causes (3 patients, 75%) and infections (1 patient, 25%) were most common. Common causes of graft loss were death with a functioning graft (4) and chronic rejection (1). Univariate analysis of risk factors showed pre transplant hypertension and diabetes mellitus significantly (p < 0.05) affected time of return to dialysis. Multivariate analysis did not show these independent variables to be significant. After censoring patients that died with functioning grafts, difference in graft survival between >60 and <59 years was not significant (p > 0.2). In this study, 92% of older patients had allografts functioning at 1 year. In conclusions, the fact that older patients succumb over time from natural causes should not keep patients from transplantation. Immunosuppressive agents need to be limited to reduce the incidence of infection. Criteria need to be refined to define those who are at prohibitive risk, who may not be candidates for transplantation.
Volume : 6
Issue : 4
Pages : 205
Department of Medicine, Salmaniya Medical complex, Bahrain