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 language | English |
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Pages (from-to) | 540-553 |
Number of pages | 14 |
Journal | Transplant International |
Volume | 31 |
Issue number | 5 |
Early online date | 30 Jan 2018 |
DOIs | |
Publication status | Published - May 2018 |
Keywords
- Elderly
- Epidemiology
- Europe
- Graft survival
- Kidney transplantation
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Professor Fergus J Caskey
- Bristol Medical School (PHS) - Professor of Renal Medicine
- Bristol Population Health Science Institute
Person: Academic , Member