Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Innsbruck Medical University, Innsbruck, Austria.
Transplantation. 2011 Jul 27;92(2):210-6. doi: 10.1097/TP.0b013e318222ca2f.
Kidney transplantation in the elderly is complicated by comorbidities and a higher incidence of death. The Eurotransplant Senior Program (ESP) has been established to allocate kidneys from older donors to the increasing number of older recipients. In this retrospective, single center data analysis, we compare the outcome of recipients older than 70 years with younger recipients transplanted under the ESP protocol.
Between 1999 and 2009, a total of 83 kidneys were transplanted under the ESP protocol in Innsbruck and 19 of the recipients were older than 70 years (mean, 72.7 years). Cold ischemia time was kept short in both groups by giving preference to regional donor organs.
Patient survival at 1 and 5 years were 95% and 67% in the 70+ group and 94.4% and 82.6% in the 70- group. Graft survival was 95% and 52% at 1 and 5 years in the 70+ group and 94.4% and 79.0% in the 70- group. When censored for death, graft survival at year 1 and 5 were 100% and 82% in the 70+ group and 98.1% and 92.7% in the 70- group. The delayed graft function rate was high in both groups (36.8% and 41.1%, respectively). Morbidities were largely related to hemodynamic, oncologic, and infectious events. Cardiac failure was the major cause of death.
Relatively good results can be achieved with renal transplantation in patients older than 70 years under careful pretransplant evaluation and postoperative management of comorbidities.
老年人进行肾移植会受到合并症的影响，且死亡率较高。欧洲肾脏移植协会老年项目（ESP）旨在将来自老年供体的肾脏分配给越来越多的老年受者。在这项回顾性、单中心数据分析中，我们比较了在 ESP 方案下接受移植的 70 岁以上老年受者与年龄较小受者的结局。
1999 年至 2009 年，因 ESP 方案在因斯布鲁克共进行了 83 例肾移植，其中 19 例受者年龄大于 70 岁（平均年龄 72.7 岁）。两组均通过优先使用区域性供体器官，将冷缺血时间保持在较短的范围内。
70 岁以上组患者 1 年和 5 年的存活率分别为 95%和 67%，70 岁以下组分别为 94.4%和 82.6%。70 岁以上组 1 年和 5 年的移植物存活率分别为 95%和 52%，70 岁以下组分别为 94.4%和 79.0%。当因死亡而被删失时，70 岁以上组患者 1 年和 5 年的移植物存活率分别为 100%和 82%，70 岁以下组分别为 98.1%和 92.7%。两组的延迟肾功能恢复率均较高（分别为 36.8%和 41.1%）。发病主要与血流动力学、肿瘤和感染事件有关。心力衰竭是主要的死亡原因。
在进行仔细的移植前评估和术后合并症管理的情况下，70 岁以上患者接受肾移植可获得相对较好的结果。
