Access to kidney transplantation in European adults aged 75–84 years and related outcomes: an analysis of the European Renal Association–European Dialysis and Transplant Association Registry

Maria Pippias*, Vianda Stel, Anneke Kramer, Jose M. Abad Diez, Nuria Aresté-Fosalba, Carole Ayav, Jadranka Buturovic, Fergus J. Caskey, Frederic Collart, Cécile Couchoud, Johan De Meester, James G. Heaf, Ilkka Helanterä, Marc H. Hemmelder, Myrto Kostopoulou, Marlies Noordzij, Julio Pascual, Runolfur Palsson, Anna Varberg Reisæter, Jamie P. TraynorZiad Massy, Kitty J. Jager

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

To what extent access to, and allocation of kidney transplants and survival outcomes in patients aged ≥75 years have changed over time in Europe is unclear. We included patients aged ≥75-84 years (termed older adults) receiving renal replacement therapy in thirteen European countries between 2005-2014. Country differences and time trends in access to, and allocation of kidney transplants were examined. Survival outcomes were determined by Cox regression analyses. Between 2005-2014, 1,392 older adult patients received 1,406 transplants. Access to kidney transplantation varied from ~0% (Slovenia, Greece and Denmark) to ~4% (Norway and various Spanish regions) of all older adult dialysis patients, and overall increased from 0.3% (2005) to 0.9% (2014). Allocation of kidney transplants to older adults overall increased from 0.8% (2005) to 3.2% (2014). Seven-year unadjusted patient and graft survival probabilities were 49.1% (95% confidence interval, 95%CI: 43.6; 54.4) and 41.7% (95%CI: 36.5; 46.8) respectively, with a temporal trend towards improved survival outcomes. In conclusion, in the European dialysis population aged ≥75-84 years access to kidney transplantation is low, and allocation of kidney transplants remains a rare event. Though both are increasing with time and vary considerably between countries. The trend towards improved survival outcomes is encouraging. This information can aid informed decision-making regarding treatment options.
Original languageEnglish
Pages (from-to)540-553
Number of pages14
JournalTransplant International
Volume31
Issue number5
Early online date30 Jan 2018
DOIs
Publication statusPublished - May 2018

Keywords

  • Elderly
  • Epidemiology
  • Europe
  • Graft survival
  • Kidney transplantation

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