Evolução a longo prazo no transplante renal de idosos

Paula Ferreira Orlandi, Marina Pontello Cristelli, Carolina Araujo Rodrigues Aldworth, Taina Veras de Sandes Freitas, Claudia Rosso Felipe, Helio Tedesco Silva, Jose Osmar Medina de Abreu Pestana

The number of elderly patients with chronic kidney disease increases progressively, challenging the allocation algorithms in a scenario of organ shortage for transplantation. To evaluate the impact of age on patient and graft survival. Evolution of all 366 patients greater than 60 years transplanted between 1998 and 2010 was analyzed versus a control group of 366 younger patients matched for gender, type of donor (living or deceased) and year of transplantation. Diabetes mellitus (HR 1.8; IC 1.2-2.6; p = 0,003) and prioritization (HR 2.9; IC 1.2-2.6; p < 0,001), but not age, were independent factors for kidney graft loss. Advanced age was not related to negative outcomes after kidney transplantation, after excluding recipient death as a cause of allograft loss. Higher mortality rate in this group was associated to a higher frequency of comorbidities, especially diabetes mellitus.