TY - JOUR
T1 - Access to kidney transplantation in European adults aged 75 to 84 years and related outcomes: An analysis of the ERA-EDTA Registry database
AU - Pippias, Maria
AU - Stel, Vianda S.
AU - Kramer, Anneke
AU - Abad Diez, Jose M.
AU - Aresté-Fosalba, Nuria
AU - Ayav, Carole
AU - Buturovic, Jadranka
AU - Caskey, Fergus J.
AU - Collart, Frederic
AU - Couchoud, Cécile
AU - de Meester, Johan
AU - Heaf, James G.
AU - Helanterä, Ilkka
AU - Hemmelder, Marc H.
AU - Kostopoulou, Myrto
AU - Noordzij, Marlies
AU - Pascual, Julio
AU - Palsson, Runolfur
AU - Reisaeter, Anna Varberg
AU - Traynor, Jamie P.
AU - Massy, Ziad
AU - Jager, Kitty J.
PY - 2018
Y1 - 2018
N2 - 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. This article is protected by copyright. All rights reserved
AB - 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. This article is protected by copyright. All rights reserved
U2 - https://doi.org/10.1111/tri.13125
DO - https://doi.org/10.1111/tri.13125
M3 - Article
C2 - 29383764
SN - 0934-0874
VL - 31
SP - 540
EP - 543
JO - Transplant international
JF - Transplant international
IS - 5
ER -