{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T12:21:17Z","timestamp":1783426877625,"version":"3.54.6"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100018936","name":"Universit\u00e4tsklinikum Heidelberg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018936","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney transplantation in older adults is expanding, but detailed data on infection burden, antibiotic resistance, and sex-specific outcomes remain limited. The aim of the present study was to characterize infection dynamics and determinants of adverse events in recipients aged\u2009\u2265\u200965\u00a0years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter cohort study, 355 kidney transplant recipients aged 65\u201380\u00a0years (67.6% male) were followed for a median of 3.8\u00a0years. Cumulative incidences of infection, graft loss, and death were determined. Independent risk factors were identified using Cox regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Delayed graft function occurred in 23.9%, S-creatinine was 1.72 IQR (1.40\u20132.45) and eGFR 38.7 (26.2\u201351.3) one year after transplantation. All-cause mortality was 3.2% at year 1 and 11.8% at year 5 after transplantation. Infectious complications were frequent, with a cumulative incidence of first infection reaching 67.6% at 1\u00a0year and 81.9% at 5\u00a0years. Bacterial infections predominated, whereas viral infections persisted throughout follow-up and fungal infections occurred mainly in the early post-transplant period. During follow-up, death with a functioning graft (DWFG) was the predominant graft-related endpoint, accounting for 35 of 48 all-cause graft loss events, with infections representing the leading attributed cause (51.4%). In multivariable analyses, prolonged initial hospital stay was consistently associated with infectious outcomes and subsequent DWFG, while delayed graft function was independently associated with increased hazard of DWFG (HR 2.54, 95% CI 1.29\u20135.00). In time-dependent analyses, fungal infections were independently associated with a higher subsequent hazard of DWFG (HR 2.67, 95% CI 1.23\u20135.77). Mortality, graft-related outcomes, and infection rates were broadly similar by sex and between recipients aged 65\u201369 and\u2009\u2265\u200970\u00a0years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Kidney transplantation in carefully selected older recipients, including those aged\u2009\u2265\u200970\u00a0years, was associated with sustained patient and graft survival. Infectious complications occurred frequently and constituted the leading attributed cause of DWFG; this underscores the importance of understanding why some recipients recover from infectious stress, while others experience subsequent clinical deterioration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12877-026-07901-0","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:28:30Z","timestamp":1783348110000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Renal transplantation in older recipients \u2013 results of the DZIF transplant cohort"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5080-0979","authenticated-orcid":false,"given":"Claudia","family":"Sommerer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Schr\u00f6ter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Schindler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Schork","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lutz","family":"Renders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Kemmner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas Michael","family":"Willerding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burkhard","family":"T\u00f6nshoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Zeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Giese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Transplant Cohort of the German Center for Infection Research (DZIF Transplant Cohort) Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nele","family":"Kanzmeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Delecluse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Neuenhahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Ganzenm\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e4rbel","family":"F\u00f6sel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Klett-Tammen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Feuchtinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"issue":"19","key":"7901_CR1","first-page":"sfag036","volume":"2026","author":"M Hoekstra","year":"2023","unstructured":"Hoekstra M, Boenink R, Bonthuis M, Boerstra B, Astley M, Montez de Sousa I, et al. 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