부산대학교 도서관

BACKGROUND:: The impact of renal transplantation (RT) in the elderly with many comorbid conditions is a matter of concern. The aim of our study was to assess the impact of renal transplantation on the survival of patients older than 60 years compared with those remaining on the WL according to their comorbidities. METHODS:: In this muticentric observational retrospective cohort study we included all patients older than 60 years old admitted on the WL from 01/01/2006 until 31/12/2016. The Charlson comorbidity index (CCI) score was calculated for each patient at inclusion on the WL. KDRI (Kidney donor risk index) was used to assess donor characteristics. RESULTS:: 1036 patients were included on the WL of which 371 (36%) received a RT during a median follow up period of 2,5 (1.4-4.1) years. Patients survival was higher after RT compared to patients remaining on the WL, 87%, 80%, 72% vs 87%, 55% y 30% at 1,3 and 5 years respectively. After RT survival at 5 years was 37% higher for patients with CCI ≥3, and 46% higher in those with CCI <3, compared with patients remaining on the WL. On univariate and multivariate analysis patients survival was independently associated with a CCI ≥3 (HR 1.62 IC 1.09-2.41 p<0.02) and the use of CNI maintenance therapy (HR 0.53 IC 0.34-0.82 p<0.004). CONCLUSION:: Our study showed that RT improved survival in patients older than 60 years even those with high comorbidities. The survival after transplantation was also affected by comorbidities.