Hany M El Hennawy, Saad Muzaffar Azeem, Omar Safar, Abdullah S Al Faifi, Eisa Al Atta, Mahmoud Z El Madawie, Galal A El Gamal, Sadia Azeem, Ibrahim Tawhari, Osama Shalkamy
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引用次数: 0
Abstract
Objectives: We evaluated living donor kidney transplant outcomes in older recipients (≥65 years) at Armed Forces Hospitals in the Southern Region from September 2017 to January 2025 and compared results versus younger recipients (<65 years).
Materials and methods: This was a retrospective analysis of 68 older patients (group A) and 316 younger patients (group B) who received tacrolimus, mycophenolate mofetil, and prednisone, with basiliximab induction in 94.1% of group A and 92% of group B. Retransplant occurred in 5.9% of group A and 7.9% of group B.
Results: Older recipients had longer dialysis durations versus younger recipients (4 vs 2 years; P < .001), longer surgeries (230 vs 180 minutes; P < .001), and longer hospital stays (7.5 vs 6.2 days; P < .001), higher rates of delayed graft function (8.8% vs 0.6%; P < .001), and lower immediate graft function (91.1% vs 97.7%; P = .006). At 1 year in group A and group B, graft survival rates (95.5% vs 97.1%; P = .501) and patient survival rates (95.5% vs 98.1%; P = .545) were similar. However, by 3 years, graft survival was lower in group A (86.7%) versus group B (92%) as was patient survival (85.2% vs 93.6%; P < .001). Graft loss within 3 years occurred in 4.4% of older versus 1.89% of younger recipients, and death with a functioning graft was more common in group A (7.3%) than in group B (2.2%). Group A also had higher rates of complications than group B (infections: 13.2% vs 6.3%; surgical site infections: 5.9% vs 0.6%).
Conclusions: Despite higher risks, group A demon-strated 1-year graft and patient survival rates that were comparable with group B, highlighting feasibility of kidney transplant in well-selected older adults. However, nonadherence was associated with higher infection rates but did not significantly affect long-term outcomes.
目的：我们评估2017年9月至2025年1月在南方地区武装部队医院的老年（≥65岁）活体肾移植受者的结果，并将结果与年轻受者进行比较(材料和方法：68年这是一个回顾性分析老年患者(a组)和316名年轻患者(B组)接受他克莫司,霉酚酸酯,和强的松,basiliximab感应在a组的94.1%和92%的再次移植发生在5.9%的a组和B组7.9%的集团B.Results:老接受者透析时间较长和年轻接受者(4和2年;P <措施),再手术(230 vs 180分钟;P <措施),住院时间较长的(7.5 vs 6.2天;P < 0.001)，延迟移植功能发生率较高（8.8% vs 0.6%, P < 0.001），即时移植功能发生率较低（91.1% vs 97.7%, P = 0.006）。A组和B组1年时，移植物存活率（95.5% vs 97.1%, P = .501）和患者生存率（95.5% vs . 98.1%, P = .545）相似。然而，到3年，A组的移植物存活率（86.7%）低于B组（92%），患者存活率（85.2%对93.6%;P < 0.001）。老年人3年内移植物丢失的发生率为4.4%，年轻人为1.89%，a组（7.3%）比B组（2.2%）更常见。A组的并发症发生率也高于B组（感染：13.2% vs 6.3%；手术部位感染：5.9% vs 0.6%）。结论：尽管风险较高，但A组的1年移植和患者生存率与B组相当，突出了在精心挑选的老年人中进行肾移植的可行性。然而，不依从性与较高的感染率相关，但对长期结果没有显著影响。
期刊介绍：
The scope of the journal includes the following:
Surgical techniques, innovations, and novelties;
Immunobiology and immunosuppression;
Clinical results;
Complications;
Infection;
Malignancies;
Organ donation;
Organ and tissue procurement and preservation;
Sociological and ethical issues;
Xenotransplantation.
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