Trends in kidney transplant outcomes in older adults

Mara Ann McAdams Demarco, Nathan James, Megan L. Salter, Jeremy D Walston, Dorry Segev

Research output: Contribution to journalArticle

Abstract

Objectives To estimate mortality and death-censored graft loss according to year of kidney transplant (KT) between 1990 and 2011.

Design Cohort study.

Setting The Scientific Registry of Transplant Recipients (SRTR).

Participants KT recipients aged 65 and older at the time of transplantation (N = 30,207).

Measurements Mortality and death-censored graft loss ascertained through center report and linkage to Social Security Death Master File and to Medicare.

Results Older adults currently account for 18.4% of KT recipients, up from 3.4% in 1990; similar increases were noted for deceased donor (5.4 times percentage increase) and live donor (9.1 times percentage increase) transplants. Current recipients are not only older, but also more likely to be female and African American, have lengthier pretransplant dialysis, have diabetes mellitus or hypertension, and receive marginal kidneys. Mortality for older deceased donor recipients between 2009 and 2011 was 57% lower (hazard ratio (HR) = 0.43, 95% confidence interval (CI) = 0.33-0.56, P

Conclusion Despite a major increase in number of older adults transplanted and an expanding window of transplant eligibility, mortality and graft loss have decreased substantially for this recipient population. These trends are important to understand for patient counseling and transplant referral.

Original languageEnglish (US)
Pages (from-to)2235-2242
Number of pages8
JournalJournal of the American Geriatrics Society
Volume62
Issue number12
DOIs
StatePublished - Dec 1 2014

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Transplants
Kidney
Mortality
Tissue Donors
Social Security
Medicare
African Americans
Registries
Counseling
Dialysis
Diabetes Mellitus
Cohort Studies
Referral and Consultation
Transplantation
Confidence Intervals
Hypertension
Population
Transplant Recipients

Keywords

  • graft loss
  • kidney transplantation
  • mortality
  • older adults

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Trends in kidney transplant outcomes in older adults. / McAdams Demarco, Mara Ann; James, Nathan; Salter, Megan L.; Walston, Jeremy D; Segev, Dorry.

In: Journal of the American Geriatrics Society, Vol. 62, No. 12, 01.12.2014, p. 2235-2242.

Research output: Contribution to journalArticle

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