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

作者：Pippias Maria^*; Stel Vianda S; Kramer Anneke; Abad Diez Jose M; Areste Fosalba Nuria; Ayav Carole; Buturovic Jadranka; Caskey Fergus J; Collart Frederic; Couchoud Cecile; De Meester Johan; Heaf James G; Helantera Ilkka; Hemmelder Marc H; Kostopoulou Myrto; Noordzij Marlies; Pascual Julio; Palsson Runolfur; Reisaeter Anna Varberg; Traynor Jamie P; Massy Ziad; Jager Kitty J

来源：Transplant International, 2018, 31(5): 540-553.

DOI：10.1111/tri.13125

• elderly
• epidemiology
• Europe
• graft survival
• kidney transplantation

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 and 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 and 2014, 1392 older adult patients received 1406 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.

• 出版日期2018-5