Graft and Quality of Life Outcomes in Older Recipients of a Kidney Transplant

Abstract

Background: It is well recognized that kidney transplants significantly improve quality of life for patients with end-stage renal disease (ESRD). This benefit is not as clearly documented for older recipients as it is for younger recipients. We looked at outcomes, both medical and psychosocial, in a group of older (≥65 years) kidney transplant recipients and compared the results to a group of younger recipients (18 to 64 years).

Methods: From 1990 through 2002, we performed 2,746 kidney transplants at our center: 2,596 (94.5%) in recipients 18 to 64 years old and 150 (5.5%) in recipients 65 years or older. In our retrospective analysis, we determined outcomes such as patient and graft survival rates. To determine whether or not older recipients had an improved health-related quality of life, we used the national SF-36 (short form) questionnaire. We compared those results with a group of younger recipients and with national age-appropriate norms.

Results: The mean recipient age was 69.1 years in the older group vs. 42.8 years in the younger group (p < 0.001). Living donors were used in 43.3% of the transplants in the older group vs. 47.5% in the younger group (p < 0.01). At 5 years posttransplant, patient and graft survival rates were 73% and 68% in the older group vs. 86% and 79% in the younger group (p < 0.001).

We analyzed the SF-36 responses for all recipients with completed forms: 42 completed forms from the older group vs. 149 from the younger group. The overall benefit to quality of life was similar for both groups. General physical health was rated slightly higher than national norms in both groups. Benefits to mental health were more pronounced in the older group.

Conclusion: Kidney transplants can be performed in older recipients with acceptable outcomes. Such recipients enjoy significant benefits to their quality of life after a transplant, similar to benefits seen in younger recipients. Older age, by itself, should not be a contraindication to a transplant.