Renal transplantation in the elderly: does patient age determine the results?

BACKGROUND: Transplantation is the best treatment for patients with chronic renal failure, including the elderly. However, the patient's age was traditionally considered as a relative contraindication for it. OBJECTIVE: To compare the results of renal transplantation in patients over and under 60 years of age. METHODS: Analysis of 621 transplant recipients in Galicia (Spain) between 1996 and 2000, divided into two groups, according to age over 60 years (484) or under 60 years (137). The actuarial method, Kaplan-Meier curves, log-rank test and Cox proportional hazard model were used to study survival. RESULTS: Graft survival for those aged under 60 years was 82% and 70% at 1 and 5 years, while it was 73% and 56% for those over 60 years. However, censuring the deceased patients with a functioning graft, it was 84% and 76% for those aged under 60 years and 83% and 77% for those over 60 years. A total of 47% of the graft losses in the group over 60 years were due to the patient's death. Overall graft survival for all the patients was greater (P<0.0001) when the donor was under 60 years of age. CONCLUSIONS: Recipient age alone cannot be a criterion to exclude patients over 60 years from transplantation, since their lower survival is influenced by comorbidity and the donor's age.