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 S 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 Reisaeter; Jamie P Traynor; Ziad Massy; Kitty J Jager

doi:10.1111/tri.13125

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 S 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 Reisaeter, Jamie P TraynorZiad Massy, Kitty J Jager

Department of Clinical Medicine

7 Citations (Scopus)

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 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.

Original language	English
Journal	Transplant International
Volume	31
Issue number	5
Pages (from-to)	540-553
ISSN	0934-0874
DOIs	https://doi.org/10.1111/tri.13125
Publication status	Published - May 2018

Keywords

Aged
Aged, 80 and over
Female
Graft Survival
Health Services Accessibility
Humans
Kidney Transplantation/mortality
Male
Registries
Renal Dialysis
Tissue and Organ Procurement

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Pippias, M., Stel, V. S., Kramer, A., Abad Diez, J. M., Aresté-Fosalba, N., Ayav, C., Buturovic, J., Caskey, F. J., Collart, F., Couchoud, C., De Meester, J., Heaf, J. G., Helanterä, I., Hemmelder, M. H., Kostopoulou, M., Noordzij, M., Pascual, J., Palsson, R., Reisaeter, A. V., ... Jager, K. J. (2018). 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. Transplant International, 31(5), 540-553. https://doi.org/10.1111/tri.13125

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. / Pippias, Maria; Stel, Vianda S; Kramer, Anneke et al.

In: Transplant International, Vol. 31, No. 5, 05.2018, p. 540-553.

Research output: Contribution to journal › Journal article › Research › peer-review

Pippias, M, Stel, VS, Kramer, A, Abad Diez, JM, Aresté-Fosalba, N, Ayav, C, Buturovic, J, Caskey, FJ, Collart, F, Couchoud, C, De Meester, J, Heaf, JG, Helanterä, I, Hemmelder, MH, Kostopoulou, M, Noordzij, M, Pascual, J, Palsson, R, Reisaeter, AV, Traynor, JP, Massy, Z & Jager, KJ 2018, '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', Transplant International, vol. 31, no. 5, pp. 540-553. https://doi.org/10.1111/tri.13125

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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 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.",

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T1 - Access to kidney transplantation in European adults aged 75-84 years and related outcomes

T2 - an analysis of the European Renal Association-European Dialysis and Transplant Association Registry

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 - 2018/5

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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 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.

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 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.

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KW - Aged, 80 and over

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KW - Health Services Accessibility

KW - Humans

KW - Kidney Transplantation/mortality

KW - Male

KW - Registries

KW - Renal Dialysis

KW - Tissue and Organ Procurement

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DO - 10.1111/tri.13125

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C2 - 29383764

SN - 0934-0874

VL - 31

SP - 540

EP - 553

JO - Transplant International

JF - Transplant International

IS - 5

ER -

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

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Keywords

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