Analysis of Complications and Recipients' and Graft Survival in Patients 60 Years of Age and Older in the Long-Term Follow-up Period After Kidney Transplant: A Single-Center, Paired Kidney Analysis

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F67985807%3A_____%2F22%3A00558619" target="_blank" >RIV/67985807:_____/22:00558619 - isvavai.cz</a>

Výsledek na webu

<a href="http://dx.doi.org/10.1016/j.transproceed.2022.03.038" target="_blank" >http://dx.doi.org/10.1016/j.transproceed.2022.03.038</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.transproceed.2022.03.038" target="_blank" >10.1016/j.transproceed.2022.03.038</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Analysis of Complications and Recipients' and Graft Survival in Patients 60 Years of Age and Older in the Long-Term Follow-up Period After Kidney Transplant: A Single-Center, Paired Kidney Analysis

Popis výsledku v původním jazyce

BACKGROUND: Long-term results of kidney transplant (KTx) in older patients may differ from younger recipients owing to increased cardiovascular comorbidities. The study aimed to analyze surgical and nonsurgical complications that develop in the long-term follow-up period after KTx, and factors that influence results of KTx in recipients aged 60 years and older (≥60) compared with younger recipients (<60). METHODS: One hundred seventy-five patients aged ≥60 years and 175 patients aged <60 years who received a kidney graft from the same deceased donor were enrolled in the study. In the long-term follow-up period (3 months to 5 years after KTx) the incidence of surgical and nonsurgical complications, as well as patient and kidney graft survival, were compared. Additionally, the influence of early complications on patients and kidney graft survival was assessed. RESULTS: There were no differences between recipients aged ≥60 years compared with recipients aged <60 years in occurrence of surgical complications (graft artery stenosis: 0.6% vs 2.3%, ureter stenosis: 3.4% vs 1.1%, lymphocele: 6.9% vs 3.4%) and nonsurgical complications (urinary tract infection: 19.4% vs 23.4%, pneumonia: 8.6% vs 8.6%, cytomegalovirus infection: 6.3% vs 8%, new-onset diabetes after transplant: 16.6% vs 17.1%, cancer incidence: 5.7% vs 4.6%, acute rejection episode: 13.1% vs 17.1%). Five-year recipient survival was lower in a group of patients aged ≥60 years (death, 15.4% vs 8%, death with functioning graft, 12% vs 5.1%). CONCLUSIONS: The incidence of surgical and nonsurgical complications, as well as kidney-graft survival, in recipients aged ≥60 years in a 5-year follow-up period is comparable to younger recipients aged <60 years. As the mean population age is growing, there is a rising number of patients aged more than 60 years registering as potential kidney graft recipients [1]. In 2020, there were 813 potential kidney recipients who were older than 60 years of age registered on the National Transplant Registry's waiting list for kidney transplant in Poland. This was about 38.7% of all patients awaiting kidney transplant [2]. Older age is related to multimorbidity, especially cardiovascular diseases, diabetes mellitus, and cancer. It is highly possible that owing to the mentioned comorbidities, older recipients will present poorer outcomes of kidney transplant (KTx), and more often they will develop postoperative complications, regardless of donor factors influence [3], [4], [5]. However, in our previous study, we proved that in the early postoperative period the rates of postoperative complications after KTx, kidney graft function, and the patient's kidney-graft survival in those aged 60 years are similar to younger recipients [6]. The credibility of these results was achieved by the application of kidney-paired analysis, which diminishes the influence of donor factors. Nevertheless, it cannot be excluded that the mentioned comorbidities and complications that develop in the early postoperative period after KTx will impact the outcomes of KTx in the older recipients in the long-term follow-up period [3,[7], [8], [9]]. The study aimed to analyze the following: surgical and nonsurgical complications that develop in the long-term follow-up period after kidney transplant, patients and kidney graft survival, and the influence of early complications on the results of kidney transplant in recipients aged 60 years and older (≥60) compared with younger recipients (<60).

Název v anglickém jazyce

Analysis of Complications and Recipients' and Graft Survival in Patients 60 Years of Age and Older in the Long-Term Follow-up Period After Kidney Transplant: A Single-Center, Paired Kidney Analysis

Popis výsledku anglicky

BACKGROUND: Long-term results of kidney transplant (KTx) in older patients may differ from younger recipients owing to increased cardiovascular comorbidities. The study aimed to analyze surgical and nonsurgical complications that develop in the long-term follow-up period after KTx, and factors that influence results of KTx in recipients aged 60 years and older (≥60) compared with younger recipients (<60). METHODS: One hundred seventy-five patients aged ≥60 years and 175 patients aged <60 years who received a kidney graft from the same deceased donor were enrolled in the study. In the long-term follow-up period (3 months to 5 years after KTx) the incidence of surgical and nonsurgical complications, as well as patient and kidney graft survival, were compared. Additionally, the influence of early complications on patients and kidney graft survival was assessed. RESULTS: There were no differences between recipients aged ≥60 years compared with recipients aged <60 years in occurrence of surgical complications (graft artery stenosis: 0.6% vs 2.3%, ureter stenosis: 3.4% vs 1.1%, lymphocele: 6.9% vs 3.4%) and nonsurgical complications (urinary tract infection: 19.4% vs 23.4%, pneumonia: 8.6% vs 8.6%, cytomegalovirus infection: 6.3% vs 8%, new-onset diabetes after transplant: 16.6% vs 17.1%, cancer incidence: 5.7% vs 4.6%, acute rejection episode: 13.1% vs 17.1%). Five-year recipient survival was lower in a group of patients aged ≥60 years (death, 15.4% vs 8%, death with functioning graft, 12% vs 5.1%). CONCLUSIONS: The incidence of surgical and nonsurgical complications, as well as kidney-graft survival, in recipients aged ≥60 years in a 5-year follow-up period is comparable to younger recipients aged <60 years. As the mean population age is growing, there is a rising number of patients aged more than 60 years registering as potential kidney graft recipients [1]. In 2020, there were 813 potential kidney recipients who were older than 60 years of age registered on the National Transplant Registry's waiting list for kidney transplant in Poland. This was about 38.7% of all patients awaiting kidney transplant [2]. Older age is related to multimorbidity, especially cardiovascular diseases, diabetes mellitus, and cancer. It is highly possible that owing to the mentioned comorbidities, older recipients will present poorer outcomes of kidney transplant (KTx), and more often they will develop postoperative complications, regardless of donor factors influence [3], [4], [5]. However, in our previous study, we proved that in the early postoperative period the rates of postoperative complications after KTx, kidney graft function, and the patient's kidney-graft survival in those aged 60 years are similar to younger recipients [6]. The credibility of these results was achieved by the application of kidney-paired analysis, which diminishes the influence of donor factors. Nevertheless, it cannot be excluded that the mentioned comorbidities and complications that develop in the early postoperative period after KTx will impact the outcomes of KTx in the older recipients in the long-term follow-up period [3,[7], [8], [9]]. The study aimed to analyze the following: surgical and nonsurgical complications that develop in the long-term follow-up period after kidney transplant, patients and kidney graft survival, and the influence of early complications on the results of kidney transplant in recipients aged 60 years and older (≥60) compared with younger recipients (<60).

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30213 - Transplantation

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2022

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Transplantation Proceedings

ISSN

0041-1345

e-ISSN

1873-2623

Svazek periodika

54

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

7

Strana od-do

948-954

Kód UT WoS článku

000887139200025

EID výsledku v databázi Scopus

2-s2.0-85133268523