{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T06:01:30Z","timestamp":1774159290636,"version":"3.50.1"},"reference-count":26,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003710","name":"KHIDI","doi-asserted-by":"crossref","award":["RS-2025-02263683"],"award-info":[{"award-number":["RS-2025-02263683"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The survival benefits of kidney transplantation (KT) versus dialysis in elderly end-stage renal disease (ESRD) patients, particularly those with cardiovascular disease (CVD), remain uncertain. Methods: This retrospective single-center study included 1060 patients aged \u226560 years: 165 KT recipients and 895 dialysis patients. Propensity score matching using five covariates (age, sex, cardiac disease, cerebrovascular accident, and hemodialysis duration) created balanced cohorts of 123 patients per group. Kaplan\u2013Meier analysis and multivariate Cox regression were performed in the matched cohort, and a time-dependent Cox model was additionally applied to the full cohort to address immortal time bias. Results: In the propensity score-matched cohort, KT (HR = 2.72, p = 0.009), age (HR = 1.13, p &lt; 0.001), and CVD morbidity (HR = 3.84, p &lt; 0.001) were independent predictors of mortality. In the time-dependent Cox analysis, KT was not significantly associated with overall survival (HR = 0.94, p = 0.837), but a significant KT \u00d7 CVD interaction was identified (HR = 3.34, p = 0.025): KT was associated with reduced mortality in patients without CVD (HR = 0.47, p = 0.121) and increased mortality in those with CVD (HR = 1.67, p = 0.174). In patients aged \u226565 years with CVD, KT recipients demonstrated significantly worse survival than dialysis patients (p = 0.004). Conclusions: After correcting for immortal time bias, KT was not significantly associated with overall survival in elderly patients. However, the significant KT \u00d7 CVD interaction suggests that CVD status is a critical determinant of transplant outcomes.<\/jats:p>","DOI":"10.3390\/jcm15062378","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T09:44:41Z","timestamp":1773999881000},"page":"2378","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Comorbidities on the Long-Term Survival Rate of Patients Aged 60 Years and Older Undergoing Deceased Donor Kidney Transplantation Versus Continued Waitlisting"],"prefix":"10.3390","volume":"15","author":[{"given":"Jae Jun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of General Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin-Myung","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye Eun","family":"Kwon","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youngmin","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joo Hee","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7611-2373","authenticated-orcid":false,"given":"Chung Hee","family":"Baek","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8140-9534","authenticated-orcid":false,"given":"Hyosang","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5018-5304","authenticated-orcid":false,"given":"Hyunwook","family":"Kwon","sequence":"additional","affiliation":[{"name":"Division of Kidney and Pancreas Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.23876\/j.krcp.20.202","article-title":"Trends in epidemiologic characteristics of end-stage renal disease from 2019 Korean Renal Data System (KORDS)","volume":"40","author":"Hong","year":"2021","journal-title":"Kidney Res. 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