International Urology and Nephrology

, Volume 37, Issue 3, pp 641–648 | Cite as

Live and Deceased Donor Kidney Transplantation in Patients Aged 75 years and Older in the United States

  • Jeanne Macrae
  • Amy L. Friedman
  • Eli A. Friedman
  • Paul Eggers


Objective: To examine the outcomes of geriatric ESRD patients selected for kidney transplantation. Design: Data were extracted from the USRDS Standard Analysis Files (SAF). All persons ages 75 and over who received a kidney transplant from 1994 to 2000 were compared with those remaining on dialysis or on a transplant waiting list. Data on mortality or removal from the waiting list were obtained from the United Network for Organ Sharing (UNOS). The main outcome measure was patient and kidney transplant survival. Results: Superior five year survival after kidney transplantation was attained by the geriatric cohort given a live donor transplant (59.9%), compared with recipients of deceased donor kidneys (40.3%), dialysis patients waiting for transplant (29.7%), and those who were not selected for kidney transplantation and remained on dialysis (12.5%). The likelihood of being removed from the waiting list for any reason was higher in this group (over 75) (30.3%) than in the 66–75 age group (26.8%). Their average annual mortality rate on the waiting list was 7.9, compared to 6.6% for those 66–75. Conclusion: Even after the age of 75 years, kidney transplantation provides substantial life prolongation and excellent graft survival.


Deceased donor ESRD Geriatric patients Kidney transplantation Live donor Prognosis USRDS 


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  1. 1.
    US Renal Data System, USRDS 2003 Annual Data Report Atlas of End-Stage Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2003.Google Scholar
  2. 2.
    Fauchald, P, Albrechtsen, D, Leivestad, T,  et al. 1988Renal replacement therapy in elderly patientsTransplant Int1131134CrossRefGoogle Scholar
  3. 3.
    Fabrizii, V, Winkelmyer, WC, Klauser, R,  et al. 2004Patient and graft survival in older kidney transplant recipients: does Age Matter?J Am Soc Nephrol1510521060CrossRefPubMedGoogle Scholar
  4. 4.
    Fritsche, L, Horstrup, J, Budde, K,  et al. 2003Old-for-old kidney allocation allows successful expansion of the donor recipient poolAm J Transplant1114341439Google Scholar
  5. 5.
    Albrechtsen, D, Leivestad, T, Sodal, G,  et al. 1995Kidney transplantation in patients older than 70 years of ageTransplant Proc27986988PubMedGoogle Scholar
  6. 6.
    Cameron, JS. 2000Renal transplantation in the elderlyInt Urol Nephrol32193201CrossRefPubMedGoogle Scholar
  7. 7.
    Friedman AL, Goker O, Kalish MA et al. Renal transplant recipients over Age 60 have diminished immune activity and a low risk of rejection. International Urology and Nephrology (in press).Google Scholar
  8. 8.
    Jassal, SV, Krahn, MD, Naglie, G,  et al. 2003J Am Soc Nephrol14187196CrossRefPubMedGoogle Scholar
  9. 9.
    Rebollo, P, Ortega, F, Baltar, JM,  et al. 2001Is the loss of health-related quality of life during renal replacement therapy lower in elderly patients than in younger patients?Nephrol Dial Trans1616751680Google Scholar
  10. 10.
    Rao, VK. 2002Kidney transplantation in older patients: benefits and risksDrugs Aging197984PubMedGoogle Scholar
  11. 11.
    Jagar, KJ, Dijk, PC, Dekker, FW,  et al. 2003The epidemic of aging in renal replacement therapy: an update on elderly patients and their outcomesClin Nephrol60352360Google Scholar
  12. 12.
    United Network for Organ Sharing, data prepared by Maureen A. McBride, PhD, senior biostatistician and Katarina Anderson, SAS analyst.Google Scholar
  13. 13.
    United Network for Organ Sharing policies at and Bylaws/policies/pdfs/policy_7.pdf.Google Scholar
  14. 14.
    Fried, TR, Gillick, MR. 1994Medical decision-making in the last six months of life: choices about limitation of careJ Am Ger Soc42303307Google Scholar
  15. 15.
    Jassal, SV, Redelmeier, DA. 2002Taking organs from the young to give to the old: is this acceptable?Transplantation74416PubMedGoogle Scholar
  16. 16.
    Gjertson, DW, Terasaki, PI, Cecka, JM,  et al. 1997Senior citizen pool for aged kidneysTrans Proc29129Google Scholar
  17. 17.
    Alfrey, EJ, Lerner, SM, Lu, AD. 2002The dual kidney transplant registryCecka, JMTerasaki, PI eds. Clinical Transplants 2001UCLA Tissue Typing LaboratoryLos Angeles107112Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Jeanne Macrae
    • 1
  • Amy L. Friedman
    • 2
  • Eli A. Friedman
    • 1
  • Paul Eggers
    • 3
  1. 1.Department of MedicineSUNY Downstate Medical CenterBrooklynUSA
  2. 2.Department of SurgeryYale University, School of MedicineNew HavenUSA
  3. 3.National Institutes of HealthNational Institute of Diabetes and Digestive and Kidney DiseasesBethesdaUSA

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