Pedroso S, Martins L, Fonseca I, Dias L, Henriques A C, Sarmento A M, Cabrita A
Nephrology and Transplant Departments, Hospital Geral de Santo António, Largo Professor Abel Salazar, 4050-011 Porto, Portugal.
Transplant Proc. 2006 Jul-Aug;38(6):1885-9. doi: 10.1016/j.transproceed.2006.06.061.
The prevalence of end-stage renal disease (ESRD) increases with advancing age. In most countries renal transplant recipients are getting older, too. Transplantation must be considered for ESRD patients older than 60 years; however, there are few data regarding outcomes in this population. We retrospectively reviewed the clinical course of recipients aged > or =60 years (n = 43) who underwent primary or repeated grafts from August 1988 to December 2004. We then compared recipient and donor characteristics as well as graft and patient survivals with recipients aged 18 to 59 years (n = 1058) who were transplanted during the same time. Donor age tended to be higher among the oldest recipient group (P < .001). Mean follow-up was significantly shorter in the group aged > or =60 years (P < .001), as our institution only recently has frequently accepted patients > or =60 years. Older recipients showed more frequent delayed graft function (P = .007), longer initial hospitalization (P = .005), and a significantly lower incidence of posttransplant acute rejection episodes (P = .015). Patient (P = .057), graft (P = .407), and death-censored graft (P = .649) survivals were not different between the two groups. Seven recipients aged > or =60 years died; the main cause of which was cardiovascular in origin. The loss of organs (n = 11) in the older patients was mainly due to death with a functioning kidney (54.5%). Our results confirm that renal transplant must be considered in selected patients older than 60 years as patient and graft survivals are similar to those of younger patients.
终末期肾病（ESRD）的患病率随年龄增长而增加。在大多数国家，肾移植受者的年龄也在增大。对于60岁以上的ESRD患者必须考虑进行移植；然而，关于这一人群的治疗结果的数据很少。我们回顾性分析了1988年8月至2004年12月期间接受初次或再次移植的60岁及以上受者（n = 43）的临床病程。然后我们将这些受者和供者的特征以及移植物和患者的生存率与同期接受移植的18至59岁受者（n = 1058）进行了比较。在年龄最大的受者组中供者年龄往往更高（P <.001）。60岁及以上组的平均随访时间明显更短（P <.001），因为我们的机构直到最近才频繁接收60岁及以上的患者。年龄较大的受者移植肾功能延迟更常见（P =.007），初始住院时间更长（P =.005），移植后急性排斥反应的发生率显著更低（P =.015）。两组之间的患者生存率（P =.05）、移植物生存率（P =.407）和死亡删失移植物生存率（P =.649）没有差异。7名60岁及以上的受者死亡；主要死因是心血管疾病。老年患者器官丢失（n = 11）主要是由于有功能的肾脏伴随死亡（54.5%）。我们的结果证实，对于选定的60岁以上患者必须考虑进行肾移植，因为患者和移植物的生存率与年轻患者相似。
