Kidney transplantation in donors and recipients over 60 at Fundación Valle del Lili in Cali, Colombia, from 2002 to 2016
Abstract
Introduction: Kidney transplant is the first-line therapy for end-stage renal disease. Patients over 60 constitute a population which is increasingly affected by this disease. However, they do not receive timely transplantation and most of them stay on dialysis treatment with a reduction of their survival time and life quality. In this study we show the results of the kidney transplants between elderly patients performed at a private tertiary care hospital in Cali, Colombia. Methods: This descriptive, cohort study includes 31 kidney transplants with donors and recipients over 60, which were carried out at Fundación Valle del Lili in Cali, Colombia, from January 2002 to March 2016. Results: The average ages were 66 for recipients and 65 for donors. In most cases (90%) deceased donors were involved. The main cause of renal disease was diabetic nephropathy. Conclusion: The survival rate for the patients who underwent this procedure at the center mentioned above is similar to the results shown in the literature all over the world. The most common complications associated with this kind of operation are malignancy, infections and cardiovascular pathologies. Candidates for this transplantation should be carefully chosen given its complexity and related complications.
References
Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. transplant recipients. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009;9 Suppl 3:S1-155.
Danovitch G, Savransky E. Challenges in the counseling and management of older kidney transplant candidates. Am J Kidney Dis. 2006;47(4 Suppl 2):S86-97.
Situación de la enfermedad renal crónica, hipertensión arterial y diabetes mellitus en Colombia 2015. Bogotá, DC: Fondo Colombiano de Enfermedades de Alto Costo; 2015.
Campbell SB, Clayton PA. A scoring system to screen elderly potential kidney transplant recipients: a simple tool for a complex task. Kidney Int. 2015;88(1):5-6.
Kasiske BL, Ramos EL, Gaston RS, Bia MJ, Danovitch GM, Bowen PA, et al. The evaluation of renal transplant candidates: clinical practice guidelines. Patient Care and Education Committee of the American Society of Transplant Physicians. J Am Soc Nephrol. 1995;6(1):1-34.
Dempster NJ, Ceresa CD, Aitken E, Kingsmore D. Outcomes following renal transplantation in older people: a retrospective cohort study. BMC Geriatr. 2013;13:79.
Oniscu GC, Brown H, Forsythe JL. How old is old for transplantation? Am J Transplant. 2004;4(12):2067-74.
Waiser J, Schreiber M, Budde K, Fritsche L, Böhler T, Hauser I, et al. Age-matching in renal transplantation. Nephrol Dial Transplant. 2000;15(5):696-700.
Metzger RA, Delmonico FL, Feng S, Port FK, Wynn JJ, Merion RM. Expanded criteria donors for kidney transplantation. Am J Transplant. 2003;3 Suppl 4:114-25.
Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant. 2011;11(10):2093-109.
Fritsche L, Hörstrup J, Budde K, Reinke P, Giessing M, Tullius S, et al. Old-for-old kidney allocation allows successful expansion of the donor and recipient pool. Am J Transplant. 2003;3(11):1434-9.
Tan L, Tai BC, Wu F, Raman L, Consigliere D, Tiong HY. Impact of Kidney Disease Outcomes Quality Initiative guidelines on the prevalence of chronic kidney disease after living donor nephrectomy. J Urol. 2011;185(5):1820-5.
Caicedo RLA, Vernaza OC, Valderrama MML, Manzi TE, Echeverri JGJ, Jimenez RDF, et al. Trasplante combinado hígado-riñón en la Fundación Valle del Lili, Cali, Colombia, experiencia de un centro. Rev Col Gastroenterol. 2016;31(2):96-101.
García PK, Canob CA, González CA, García RL, Arroyave M. Trasplante renal en mayores de 60 años en un hospital de Colombia. Rev Esp Geriatr Gerontol. 2014;49(3):125-8.
Frei U, Noeldeke J, Machold-Fabrizii V, Arbogast H, Margreiter R, Fricke L, et al. Prospective age-matching in elderly kidney transplant recipients, a 5-year analysis of the Eurotransplant Senior Program. Am J Transplant. 2008;8(1):50-7.
Huang E, Poommipanit N, Sampaio MS, Kuo HT, Reddy P, Gritsch HA, et al. Intermediate-term outcomes associated with kidney transplantation in recipients 80 years and older: an analysis of the OPTN/UNOS database. Transplantation. 2010;90(9):974-9.
Wolfe RA, Ashby VB, Milford EL, Ojo AO, Ettenger RE, Agodoa LY, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med. 1999;341(23):1725-30.
Rao PS, Merion RM, Ashby VB, Port FK, Wolfe RA, Kayler LK. Renal transplantation in elderly patients older than 70 years of age: results from the Scientific Registry of Transplant Recipients. Transplantation. 2007;83(8):1069-74.
Bueno V. Kidney transplantation in elderly. Curr Trends Immunol. 2014;15(6):35-42.
US Renal Data System 2014 Annual Data Report: Epidemiology of Kidney Disease in the United States. Chapter 2: Identification and Care of Patients With Chronic Kidney Disease. Am J Kidney Dis. 2015;66(1,Suppl 1):S23-S30.
Voiculescu A, Schlieper G, Hetzel GR, Hollenbeck M, Ivens K, Willers R, et al. Kidney transplantation in the elderly: age-matching as compared to HLAmatching: a single center experience. Transplantation. 2002;73(8):1356-9.
