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Volume 27, Issue 131, January 2023

Outcomes following renal transplantation in elderly: A retrospective cohort study in a single tertiary care center

Abdulrahman Altamimi^1♦, Samar Algahtani², Leenah Aloufi², Elham Alharthi², Alaa Alselaimy², Badriah Alanazi², Norah Alharbi², Bayan Albdah³

¹Consultant of Hepatobiliary and abdominal organs transplant surgeon at King Abdulaziz Medical City (KAMC), Associate professor in the College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Department of Biostatistics-King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia
²Medical intern, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Kingdom of Saudi Arabia
³Biostatistician at King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia

^♦Corresponding author
Consultant of Hepatobiliary and abdominal organs transplant surgeon at King Abdulaziz Medical City (KAMC), Associate professor in the College of Medicine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Department of Biostatistics-King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia

ABSTRACT

Introduction: With the increasing number of elderly patients with end-stage renal disease, there is a growing use of renal replacement therapy. This includes dialysis or kidney transplantation (KT), with transplantation being the favorable option due to its decreased mortality rate. Objective: We aim to report our experience with KT outcomes in patients aged =65 at our center. Methods: This is a retrospective cohort study that reviewed elderly patients who underwent KT from January 2016 to December 2021 in Riyadh, Saudi Arabia. 38 patients who met our criteria were included. All statistical analyses were performed using SAS software. Results: Out of the 38 kidney donors, 24 were living relatives, 11 were living non-relatives and 3 were cadavers. Patients who stayed in the hospital for >8 days after transplantation had more complications, such as infections (38.89%), delayed graft function (11.11%) and new-onset diabetes (5.56%), than those who stayed less. The mean serum creatinine before transplant and six months post-transplant showed a statistically significant difference with a p-value of <0.0001. Post-transplant complications reported in patients include infection (34.21%), acute kidney injury (13.16%) and biopsy-proven acute rejection (5.26%). The estimated glomerular filtration rate (eGFR) greatly improved in patients after transplantation; when comparing the eGFR at 6 months and 12 months posttransplant, there was a statistically significant difference (p-value = 0.0056). Conclusion: Our study showed that KT in patients aged =65 yielded good outcomes, indicating that age alone should not be a contraindication to transplantation.

Keywords: Chronic kidney disease, Elderly, Kidney transplant, Saudi Arabia, Outcomes