Is preemptive kidney transplantation beneficial in elderly kidney recipients?: A comparative, multicentre national study.
62nd ERA Congress, Vienna, Avusturya, 4 - 07 Haziran 2025, cilt.40, ss.1629-1630, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Cilt numarası: 40
- Basıldığı Şehir: Vienna
- Basıldığı Ülke: Avusturya
- Sayfa Sayıları: ss.1629-1630
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet
Özet
Background and Aims: Preemptive kidney transplantation is known to be associated with longer allograft and patient survival. However, there is limited data in the literature regarding the outcomes of preemptive kidney transplantation in elderly kidney transplant recipients. In this study, we aimed to investigate the effects of preemptive kidney transplantation on patient and graft survival in elderly kidney transplant recipients. Method: Our study is based on a retrospective analysis of data from 17 centers that performed kidney transplantation in patients aged 50 years and older between 2015 and 2020. Patients were divided into two groups: preemptive and non-preemptive groups. The endpoints of the study were graft loss, functional graft death and all-cause mortality. Results: A total of 1305 kidney recipients, 366 preemptive and 939 non-preemptive, were included in the study. The median age of the patients was 56 years and 39.4% were female. The median follow-up period was 63 (6–115) months and 65 (6–114) months, respectively (P = 0.640). Body mass index, living donor transplantation rate and presence of hypertension were significantly higher in the preemptive group (P < 0.001 for each). In addition, the use of anti-lymphocyte globulin (ATLG) as induction therapy, duration and dose of treatment, and delayed graft function were significantly lower in the preemptive group than in the non-preemptive group (P = 0.028, P = 0.003, P < 0.001, P < 0.001, respectively). The rates of graft loss, death with a functioning graft and all-cause mortality were significantly lower in the preemptive group compared to the non-preemptive group (P = 0.012, P = 0.006, P = 0.002, respectively). Kaplan-Meier analysis showed that patient and graft survival in the preemptive group was better than in the non-preemptive group (P = 0.018 and P = 0.024, respectively). Furthermore, Cox regression analysis showed that only preemptive kidney transplantation reduced all-cause mortality by 40% (HR:0.62, CI 95%: 0.42–0.93; P = 0.02). Conclusion: In elderly kidney transplant recipients, preemptive kidney transplantation provides longer patient, and graft survival compared to non-preemptive approach. These findings suggest that preemptive kidney transplantation should be preferred in elderly end-stage renal failure patients