SynthesisTransplantation2011
Age, exclusion criteria, and generalizability of randomized trials enrolling kidney transplant recipients.
Synthesis in Transplantation, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed.
- Age-specific impact of different immunosuppressive regimens on kidney transplant outcomes: clinical evidence from the scientific registry of transplant recipients.Frontiers in nephrology · 2026Article
- Underrepresentation of older patients in clinical trials in nephrology.Clinical kidney journal · 2025Article
- Article
- Aging and chronic kidney disease: epidemiology, therapy, management and the role of immunity.Clinical kidney journal · 2024Review
- Impact of Immunosenescence in Older Kidney Transplant Recipients: Associated Clinical Outcomes and Possible Risk Stratification for Immunosuppression Reduction.Drugs & aging · 2024Review
- Article
- Improving Cancer Care for Patients With CKD: The Need for Changes in Clinical Trials.Kidney international reports · 2022Review
- Immunosuppression Considerations for Older Kidney Transplant Recipients.Current transplantation reports · 2021Article
- CTLA4-Ig prolongs graft survival specifically in young but not old mice.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Outcomes of sirolimus regimens in 65-year-old and older kidney transplant recipients: a registry-based observational study.International urology and nephrology · 2019Observational
- Risk Factors for Early Graft Failure and Death After Kidney Transplantation in Recipients Older Than 70 Years.Kidney international reports · 2019Article
- Rapamycin Prolongs Graft Survival and Induces CD4+IFN-γ+IL-10+ Regulatory Type 1 Cells in Old Recipient Mice.Transplantation · 2018Article
- Age-Dependent Metabolic and Immunosuppressive Effects of Tacrolimus.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2017Article
- A Rationale for Age-Adapted Immunosuppression in Organ Transplantation.Transplantation · 2015Review
- Representativeness of patients enrolled in influential clinical trials: a comparison of substance dependence with other medical disorders.Journal of studies on alcohol and drugs · 2013Article
- Managing transplant rejection in the elderly: the benefits of less aggressive immunosuppressive regimens.Drugs & aging · 2013Article
- Lower calcineurin inhibitor doses in older compared to younger kidney transplant recipients yield similar troughs.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundThe proportion of elderly (≥65 years) kidney transplant recipients (KTRs) doubled in the United States from 1999 to 2008. Given higher mortality, more medication side effects, and less rejection among elderly KTRs, optimal care of these patients may require tailored decisions about transplant therapeutics. It is unknown whether participants in transplant clinical trials-which generate the best evidence for patient care-are representative of the aging population of KTRs.
methodsUsing PubMed, we identified randomized trials involving KTRs from 1999 to 2008 and determined age-exclusion criteria and the mean age of participants. The mean age of these trial participants was compared with the mean age of the overall population of incident KTRs in the United States.
resultsThe 87,222 participants in 573 trials were significantly younger than the US KTR population (P<0.05). This age discrepancy worsened over the study period (during the years 2006 to 2008, the mean age was 45 years for trial participants versus 50 years for US KTRs, P<0.05). Thirty percent of trials had an exclusion criterion based on older age, and 16% excluded recipients aged 65 years or older. In multivariable regression, immunosuppression trials (P<0.01) and trials in higher impact journals (P=0.03) were more likely to exclude the elderly, but there was no significant difference in exclusion of elderly patients based on a trial's geographic location.
conclusionsTrial participants are younger than KTRs in the United States and many trials exclude older patients. Transplant investigators should make strong efforts to recruit patients across the total age spectrum.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.