{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:59:03Z","timestamp":1753894743639,"version":"3.41.2"},"reference-count":31,"publisher":"Associacao Brasileira de Transplantes de Orgaos","issue":"1","license":[{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJT"],"abstract":"<jats:p>Objectives: The prevalence of end-stage renal disease is rising among older adults worldwide. Despite kidney transplantation being considered the best renal replacement therapy, it presents unique challenges in elderly patients. This study aims to describe deceased donor kidney transplantation in our center, analyze outcomes namely delayed graft function (DGF), acute rejection, bacterial infections, and death-censored allograft loss in patients aged 65 years or older, and compare graft and patient survival with recipients younger than 65 years old. Methods: A single-center retrospective cohort study of kidney transplantation from a deceased donor between 2016 and 2020 was conducted. Data on donor, recipient, and transplant characteristics were collected, and outcomes after transplantation were analyzed.  Univariate  Cox  regression  was  used  to  compare  patient  and  death-censored  allograft  survival  between  older  and  younger  patients. Results:  Of  the  294  deceased-donor  transplants  performed,  48  were  allocated  to  recipients  aged  65  years  or  older.  These  patients had a significantly higher prevalence of extended criteria donors (ECD) when compared to younger recipients (p &lt; 0.001). The  mean  recipient  age  in  the  elderly  group  was  68  \u00b1  2  years,  with  a  median  follow-up  of  29  months  (interquartile  range  [IQR]  18-49).  During  the  1st  year,  five  (10.4%)  patients  were  diagnosed  with  biopsy-proven  acute  rejection  and  24  (50%)  with  bacterial  infections.  DGF  was  observed  in  27  (56.3%)  patients  and  was  associated  with  a  higher  proportion  of  high-risk  donors  (ECD  and  uncontrolled  circulatory  death  donors  with  normothermic  regional  perfusion)  (p  =  0.034),  longer  cold  ischemic  times  (p  =  0.031),  and hospitalization duration (p &lt; 0.001). Death-censored allograft survival at 1, 3, and 5 years was 89.1, 89.1, and 84.6%, respectively, which was not statistically different from the group of younger recipients (p = 0.56). Throughout follow-up, five patients died, three (60%) of whom had a functioning allograft. Patient survival at 1, 3, and 5 years was 100, 97.6, and 79.2%, respectively, again showing no notable differences compared to younger recipients (p = 0.12). Conclusion: Even though an individualized approach and careful pre-transplant evaluation are key for the success of kidney transplantation in the elderly population, our 1, 3, and 5-year death-censored allograft and patient survival in older patients were similar to younger recipients.<\/jats:p>","DOI":"10.53855\/bjt.v27i1.580_eng","type":"journal-article","created":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T11:20:16Z","timestamp":1717240816000},"source":"Crossref","is-referenced-by-count":0,"title":["Kidney Transplantation in Elderly Recipients: Five-Year Experience"],"prefix":"10.53855","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4601-0920","authenticated-orcid":false,"given":"N\u00faria","family":"Paulo","sequence":"first","affiliation":[{"name":"Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1399-7988","authenticated-orcid":false,"given":"V\u00edtor","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5799-0883","authenticated-orcid":false,"given":"Ana","family":"Cerqueira","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o"}]},{"given":"Manuela","family":"Bustorff","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9115-4683","authenticated-orcid":false,"given":"Ana","family":"Pinho","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8626-9235","authenticated-orcid":false,"given":"Susana","family":"Sampaio","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1482-2024","authenticated-orcid":false,"given":"Manuel","family":"Pestana","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o"}]}],"member":"32043","published-online":{"date-parts":[[2024,5,28]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Lemoine M, Beauport DT, Lobbedez T, Choukroun G, Ligny BH, Hazzan M, et al. Risk factors for early graft failure and death after kidney transplantation in recipients older than 70 years. Kidney Int Rep 2019;4(5):656-66. https:\/\/doi.org\/10.1016\/j.ekir.2019.01.014","DOI":"10.1016\/j.ekir.2019.01.014"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Singh P, Ng YH, Unruh M. Kidney Transplantation among the elderly: challenges and opportunities to improve outcomes. Adv Chronic Kidney Dis 2016;23(1):44-50. https:\/\/doi.org\/10.1053\/j.ackd.2015.11.002","DOI":"10.1053\/j.ackd.2015.11.002"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Rebollo P, Ortega F, Baltar JM, Badia X, Alvarez-Ude F, Diaz-Corte C, et al. Health related quality of life (HRQOL) of kidney transplanted patients: variables that influence it. 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