Perioperative and long-term outcomes in octogenarians after kidney transplantation: The US perspective

Background: We aimed to study outcomes on octogenarian patients undergoing kidney transplantation in the US. Methods: We queried the UNOS dataset from 1988 through 2013 and found 471 octogenarians transplanted during the study period. Results: 86 (18.3%) were female and 385 (81.7%) were male with a mean age of 81.58 years. The octogenarians had a significantly higher incidence of diabetes, at 17.2% compared to 13.7% in the non-octogenarian group (p < 0.001). The mean donor age was 50.32 years in the octogenarian group vs. 38.02 years in the younger group (p < 0.001). The cold ischemic time of the octogenarian group was 16.72 hours vs. 14.29 hours in non-octogenarians (p < 0.001). Length of stay (LOS) was increased by 1 day in the octogenarians. We demonstrated that patients with age ≥ 80 have a 2.2-fold increased risk of perioperative death. The Cox analysis demonstrated that octogenarians have a 3.2-fold and 84% increased risk of graft failure and decreased survival, respectively. Conclusion: Octogenarians have significantly increased LOS, perioperative mortality, and rates of graft loss. Age older than 80 was an independent risk factor associated with decreased patient survival. Future studies should address differences in outcomes and quality of life of octogenarians on dialysis compared to those after kidney transplantation.