Early Complications After Kidney Transplantation in Patients Aged 60 Years and Older: A Single-Center, Paired-Kidney Analysis

• Published in: Transplantation proceedings 2020-10, Vol.52 (8), p.2376-2381
• Main Authors: Skrabaka, Damian, Franczyk, Szymon, Kolonko, Aureliusz, Sekta, Sylwia, Czerwiński, Jarosław, Owczarek, Aleksander, Valenta, Zdenek, Król, Robert, Więcek, Andrzej, Ziaja, Jacek
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Creatinine - blood; Female; Graft Survival; Humans; Incidence; Kidney - physiopathology; Kidney Transplantation - adverse effects; Male; Middle Aged; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Renal Dialysis; Retrospective Studies; Transplants - physiopathology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2020.01.093

As the population ages, the number of people suffering from cardiovascular diseases (CVD) and diabetes mellitus (DM) increases. The coexistence of these diseases can affect the results of kidney transplantation (KT) in the elderly. The aim of this study was to analyze surgical and nonsurgical complications in the early period after KT and to identify the factors that influence their development in recipients aged ≥ 60 years compared to younger recipients < 60 years. One hundred seventy-five recipients of KT ≥ 60 years and 175 recipients of KT < 60 years who received kidneys from the same deceased donor were enrolled into the study. The incidence of surgical and nonsurgical complications, factors that may influence their development, early graft function, and patient and kidney-graft survival were analyzed during a 3-month follow-up period. Donor sources complied with the Helsinki Congress and Istanbul Declaration and organs were not procured from prisoners and individuals who were coerced or paid. Older recipients were characterized by higher body mass index ± SD (26.1 ± 3.5 vs 24.7 ± 3.4 kg/m2) and suffered more often from pretransplant DM (20.6% vs 11.4%) and CVD (34.3% vs 10.3%) and less frequently underwent previous KT (6.3% vs 20.0%). There were no differences between the ≥ 60 year old and < 60 year old groups in reference to surgical (20.6% vs 24%) and nonsurgical complications (28.6% vs 27.4%), early graft function, serum creatinine, and proteinuria. Recipients (95.4% vs 97.1%) and kidney-graft survival (93.1% vs 95.4%) were similar in both groups. The recipient factors that influenced the development of infectious complications were age, dialysis duration, pretransplant DM, and CVD. Despite higher co-incidence of CVD and DM, the risk of surgical and nonsurgical complications in elderly recipients is comparable to younger recipients in the early period after KT. •Surgical complication rates are the same in younger and older recipients of kidney transplants.•Recipients with diabetes mellitus or cardiovascular disease are at higher risk for infectious complications.•Early kidney graft function and survival are similar in younger and older recipients of kidney transplants.