Kidney Retransplantation in the Elderly: Are the Benefits Worth the Risks?
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2025
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| author | Syed S. Mujtahedi Colleen L. Jay Natalia Sakhovskaya Amber Reeves‐Daniel Alejandra Mena‐Gutierrez Christopher J. Webb Emily K. E. McCracken Alan C. Farney Giuseppe Orlando Jigish Vyas Arianna Cabrales Robert J. Stratta |
| author_facet | Syed S. Mujtahedi Colleen L. Jay Natalia Sakhovskaya Amber Reeves‐Daniel Alejandra Mena‐Gutierrez Christopher J. Webb Emily K. E. McCracken Alan C. Farney Giuseppe Orlando Jigish Vyas Arianna Cabrales Robert J. Stratta Syed S. Mujtahedi Colleen L. Jay Natalia Sakhovskaya Amber Reeves‐Daniel Alejandra Mena‐Gutierrez Christopher J. Webb Emily K. E. McCracken Alan C. Farney Giuseppe Orlando Jigish Vyas Arianna Cabrales Robert J. Stratta |
| collection | Wiley Open Access |
| contents | Kidney Retransplantation in the Elderly: Are the Benefits Worth the Risks? Syed S. Mujtahedi Colleen L. Jay Natalia Sakhovskaya Amber Reeves‐Daniel Alejandra Mena‐Gutierrez Christopher J. Webb Emily K. E. McCracken Alan C. Farney Giuseppe Orlando Jigish Vyas Arianna Cabrales Robert J. Stratta Clinical Transplantation AbstractIntroductionAn increasing number of elderly patients are undergoing either primary kidney transplantation (PrKT) or retransplantation (ReKT).MethodsSingle‐center retrospective cohort study of all deceased donor KTs (DDKTs) performed in elderly patients (age ≥65 years).ResultsFrom December 2004 through August 2022, we performed 668 DDKTs in elderly patients including 39 ReKTs and 629 PrKTs. Mean donor age was lower in the ReKT group (44 ± 17 ReKT vs. 54 ± 13 years PrKT), as was KDPI (58 ± 24 vs. 74 ± 21% PrKT, both p < 0.05). A total of 44% of ReKT patients had a cPRA level above 50% compared to 10.3% PrKT (p < 0.0001). Rates were comparable between groups for primary nonfunction (2.6% ReKT vs. 3.7% PrKT) and delayed graft function (23% ReKT vs. 32% PrKT, p = 0.29). Five‐year patient (55.2% ReKT vs. 74.3% PrKT, p = 0.03) and graft survival rates (GSRs, 55.2% ReKT vs. 64.7% PrKT, p = 0.32) were higher in the PrKT group. Death with functioning graft (DWFG) occurred in 59% of ReKT versus 37.4% of PrKT patients (p = 0.01) and accounted for 79.3% ReKT and 65.3% PrKT graft losses. Death‐censored GSRs were not different (62.5% ReKT vs. 68.3% PrKT, p = 0.6).ConclusionsElderly recipients of deceased donor ReKTs have a higher risk of DWFG, but death‐censored outcomes are comparable to age‐matched PrKT recipients. 10.1111/ctr.70129 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.70129 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70129 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Kidney Retransplantation in the Elderly: Are the Benefits Worth the Risks? Syed S. Mujtahedi Colleen L. Jay Natalia Sakhovskaya Amber Reeves‐Daniel Alejandra Mena‐Gutierrez Christopher J. Webb Emily K. E. McCracken Alan C. Farney Giuseppe Orlando Jigish Vyas Arianna Cabrales Robert J. Stratta Clinical Transplantation Kidney Retransplantation in the Elderly: Are the Benefits Worth the Risks? Syed S. Mujtahedi Colleen L. Jay Natalia Sakhovskaya Amber Reeves‐Daniel Alejandra Mena‐Gutierrez Christopher J. Webb Emily K. E. McCracken Alan C. Farney Giuseppe Orlando Jigish Vyas Arianna Cabrales Robert J. Stratta Clinical Transplantation AbstractIntroductionAn increasing number of elderly patients are undergoing either primary kidney transplantation (PrKT) or retransplantation (ReKT).MethodsSingle‐center retrospective cohort study of all deceased donor KTs (DDKTs) performed in elderly patients (age ≥65 years).ResultsFrom December 2004 through August 2022, we performed 668 DDKTs in elderly patients including 39 ReKTs and 629 PrKTs. Mean donor age was lower in the ReKT group (44 ± 17 ReKT vs. 54 ± 13 years PrKT), as was KDPI (58 ± 24 vs. 74 ± 21% PrKT, both p < 0.05). A total of 44% of ReKT patients had a cPRA level above 50% compared to 10.3% PrKT (p < 0.0001). Rates were comparable between groups for primary nonfunction (2.6% ReKT vs. 3.7% PrKT) and delayed graft function (23% ReKT vs. 32% PrKT, p = 0.29). Five‐year patient (55.2% ReKT vs. 74.3% PrKT, p = 0.03) and graft survival rates (GSRs, 55.2% ReKT vs. 64.7% PrKT, p = 0.32) were higher in the PrKT group. Death with functioning graft (DWFG) occurred in 59% of ReKT versus 37.4% of PrKT patients (p = 0.01) and accounted for 79.3% ReKT and 65.3% PrKT graft losses. Death‐censored GSRs were not different (62.5% ReKT vs. 68.3% PrKT, p = 0.6).ConclusionsElderly recipients of deceased donor ReKTs have a higher risk of DWFG, but death‐censored outcomes are comparable to age‐matched PrKT recipients. 10.1111/ctr.70129 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Kidney Retransplantation in the Elderly: Are the Benefits Worth the Risks? |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70129 |