Patient and Graft Survival in the Elderly Kidney Transplant Recipients
PDF (Español)
XML (Español)


Kidney transplant, graft survival, patient survival, elderly, aging.

How to Cite

Sanchez-Avila Y, Patiño-Jaramillo N, Garcia Lopez A, Giron-Luque F. Patient and Graft Survival in the Elderly Kidney Transplant Recipients. Rev. Colomb. Nefrol. [Internet]. 2021 Feb. 16 [cited 2024 Jul. 25];8(2):e512. Available from:


Background: Kidney transplantation is considered the most effective renal replacement therapy for chronic kidney disease. Recently, kidney transplantation is increasing in elderly recipients. Aged patients who have a kidney transplant have relevant advantages compared to dialysis reported in the literature such as better survival.

Objective: We aimed to assess graft and patient survival in a cohort of elderly kidney transplant recipients.  

Materials and Methods: We retrospectively analyzed a cohort of 193 patients older than 60 years who received a kidney transplant from 2008 to 2019 in our transplant centers. Our study included sociodemographic and clinical variables to determine patient and graft survival at 1, 5 and 10 years after kidney transplantation using the Kaplan-Meier method. Cox regression analysis was used to evaluate the potential risk factors for graft loss during the first year of transplantation. 

Results: The mean recipient age was 64.62 ± 3.82 years old. The 1, 5 and 10-year death-censored graft survival rates were 90%, 86% and 75% and uncensored graft survival probability was 82%, 63% and 43% at 1, 5 and 10 years, respectively. The main mortality causes were infections and cardiovascular disease.  Patient survival was 89%, 70% and 55% at 1, 5 and 10 years, respectively. Independent graft loss risk factors in the first year posttransplant were: age >70 (HR 4.2; 95% CI 1.1-15.3), female sex (HR 2.7; 95% CI 1.01-7.3) and non-compliance (HR 8.1; 95% CI 2.1-30.7).  

Conclusion: We found that older patients experience good outcomes following renal transplantation. There is a need to determine suitable older recipients based on objective selection criteria where age should not be a barrier to the kidney transplant.
PDF (Español)
XML (Español)


1. WHO. Informe mundial sobre el envejecimiento y la salud. 2015. 2-6 p.
2. Adani GL, Baccarani U, Crestale S, Pravisani R, Isola M, Tulissi P, et al. Kidney Transplantation in Elderly Recipients: A Single-Center Experience. Transplant Proc [Internet]. 2019;51(1):132–5. Disponible en:
3. Yoo KD, An JN, Kim CT, Cho JH, Kim CD, Park SK, et al. Clinical outcomes in Asian elderly kidney transplant recipients: A multicenter cohort study. Transplant Proc. 2015;47(3):600–7.
4. Kwok W-H, Yong S-P, Kwok O-L. Outcomes in elderly patients with end-stage renal disease: Comparison of renal replacement therapy and conservative management. Hong Kong J Nephrol [Internet]. 2016;19:42–56. Disponible en:
5. Schold J, Srinivas TR, Sehgal AR, Meier-Kriesche H-U. Half of kidney transplant candidates who are older than 60 years now placed on the waiting list will die before receiving a deceased-donor transplant. Clin J Am Soc Nephrol [Internet]. 2009/06/18. julio de 2009;4(7):1239–45. Disponible en:
6. Segall L, Nistor I, Pascual J, Mucsi I, Guirado L, Higgins R, et al. Criteria for and Appropriateness of Renal Transplantation in Elderly Patients with End-Stage Renal Disease: A Literature Review and Position Statement on Behalf of the European Renal Association-European Dialysis and Transplant Association Descartes Worki. Transplantation. 2016;100(10):e55–65.
7. Arcos E, José Pérez-Sáez M, Comas J, Lloveras J, Tort J, Pascual J. Assessing the Limits in Kidney Transplantation: Use of Extremely Elderly Donors and Outcomes in Elderly Recipients. Transplantation. 2020;104(1):176–83.
8. Wright LS. Kidney Transplantation in Older Adult Recipients. Nephrol Nurs J. 2018;45(5).
9. Salud IN de. Situación del trasplante renal en Colombia - Cuenta de alto costo. 2015;1–66.
10. Segall L, Nistor I, Pascual J, Mucsi I, Guirado L, Higgins R, et al. Criteria for and Appropriateness of Renal Transplantation in Elderly Patients with End-Stage Renal Disease: A Literature Review and Position Statement on Behalf of the European Renal Association-European Dialysis and Transplant Association Descartes Worki. Transplantation. 2016;100(10):e55--e65.
11. Carmen Maand Martín R, Conejos C, Amaranta A, Díaz F, Mirada C, Esther A, et al. Calidad de vida y trasplante renal en mayores de 65 años. 2009;12(1):26–30.
12. van der Veer SN, van Biesen W, Bernaert P, Bolignano D, Brown EA, Covic A, et al. Priority topics for European multidisciplinary guidelines on the management of chronic kidney disease in older adults. Int Urol Nephrol. 2016;48(6):859–69.
13. Arias Y, Salinas M, Rivera T, Sanchez C, Nuñez S. Informe anual Red de Donacio?n y Trasplantes, Colombia, 2017. Inst Nac Salud. 2017;7(1):1–91.
14. Organ Procurement & Transplantation Network Data. Transplants in the U.S. by Recipient Age. 2019;1–2.
15. Kramer A, Pippias M, Noordzij M, Stel VS, Andrusev AM, Aparicio-madre MI, et al. The European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Registry Annual Report 2016: a summary. Zool J Linn Soc. 2019;1–19.
16. Downing K, Jones LL. A qualitative study of turning points or aha! moments in older adults’ discussions about organ donation. Prog Transplant. 2018;28(3):207–12.
17. Pinter J, Hanson CS, Chapman JR, Wong G, Craig JC, Schell JO, et al. Perspectives of older kidney transplant recipients on kidney transplantation. Clin J Am Soc Nephrol. 2017;12(3):443–53.
18. Colin R. Lenihan, Michael P. Hurley JCT. Comorbidities and Kidney Transplant Evaluation in the Elderly. Am J Nephrol. 2013;38(3):204–11.
19. Schaeffner ES, Rose C, Gill JS. Access to kidney transplantation among the elderly in the united states: A glass half full, not half empty. Clin J Am Soc Nephrol. 2010;5(11):2109–14.
20. Neri F, Furian L, Cavallin F, Ravaioli M, Silvestre C, Donato P, et al. How does age affect the outcome of kidney transplantation in elderly recipients? Clin Transplant. octubre de 2017;31(10).
21. United Network for Organ Sharing (UNOS). Transplants by Donor Type and Recipient Age. 2019;1–2.
22. Gheith O, Halim MA, Al-Otaibi T, El-Sayed A, Nair P, Mahmoud T, et al. Elderly Kidney Transplant Recipients: Single-Center Experience in the Middle East. Exp Clin Transplant. 2019;17:135–41.
23. Lemoine M, Titeca Beauport D, Lobbedez T, Choukroun G, Hurault de Ligny B, Hazzan M, et al. Risk Factors for Early Graft Failure and Death After Kidney Transplantation in Recipients Older Than 70 Years. Kidney Int Reports. 2019;4(5):656–66.
24. Hatamizadeh P, Molnar MZ, Streja E, Lertdumrongluk P, Krishnan M, Kovesdy CP, et al. Recipient-related predictors of kidney transplantation outcomes in the elderly. Clin Transplant. 2013;27(3):436–43.
25. Orlandi PF, Cristelli MP, Aldworth CAR, Freitas TV de S, Felipe CR, Silva Junior HT, et al. Long-term outcomes of elderly kidney transplant recipients. J Bras Nefrol. 2015;37(2):212–20.
26. Covert KL, Fleming JN, Staino C, Casale JP, Boyle KM, Pilch NA, et al. Predicting and preventing readmissions in kidney transplant recipients. Clin Transplant. 2016;30(7):779–86.
27. Lai X, Chen G, Qiu J, Wang C, Chen L. Recipient-related risk factors for graft failure and death in elderly kidney transplant recipients. PLoS One. 2014;9(11):1–7.
28. Fabrizii V, Winkelmayer WC, Klauser R, Kletzmayr J, Säemann MD, Steininger R, et al. Patient and Graft Survival in Older Kidney Transplant Recipients: Does Age Matter? J Am Soc Nephrol. 2004;15(4):1052–60.
29. Sato Y, Yanagita M. Immunology of the ageing kidney. Nat Rev Nephrol. 2019;
30. Seyda M, Quante M, Uehara H, Slegtenhorst BR, Elkhal A, Tullius SG. Immunosenescence in renal transplantation. Curr Opin Organ Transplant. 2015;20(4):417–23.
31. Power A, Brown E. Optimising treatment of end-stage renal disease in the elderly. Nephron - Clin Pract. 2013;124(3–4):202–8.
32. Tullius SG, Milford E. Kidney allocation and the aging immune response. Vol. 364, New England Journal of Medicine. Massachussetts Medical Society; 2011. p. 1369–70.
33. Hod T, Goldfarb-Rumyantzev AS. Clinical issues in renal transplantation in the elderly. Clin Transplant. 2015;29(2):167–75.
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright (c) 2021 Revista Colombiana de Nefrología




Download data is not yet available.