Evidence map›Paper›PMID 37928483›Full record

ArticleTransplantation direct2023

Evolving Trends in Kidney Transplant Outcomes Among Older Adults: A Comparative Analysis Before and During the COVID-19 Pandemic.

Yiting Li, Gayathri Menon, Wenbo Wu, Amrusha Musunuru, Yusi Chen, Evelien E Quint, Maya N Clark-Cutaia, Laura B Zeiser, Dorry L Segev, Mara A McAdams-DeMarco

Open access · goldAbstract read
In one paragraph

Article in Transplantation direct, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. New kidneys, old risks: cardiovascular challenges after transplantation.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Review
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 2 countries.

Yiting LiDepartment of Surgery, New York University Grossman School of Medicine, New York, NY.ORCID https://orcid.org/0000-0001-6279-5740
Gayathri MenonDepartment of Surgery, New York University Grossman School of Medicine, New York, NY.
Wenbo WuDepartment of Population Health, New York University Grossman School of Medicine, New York, NY.
Amrusha MusunuruDepartment of Surgery, New York University Grossman School of Medicine, New York, NY.
Yusi ChenDepartment of Surgery, New York University Grossman School of Medicine, New York, NY.
Evelien E QuintDivision of Transplant Surgery, Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Maya N Clark-CutaiaDepartment of Medicine, New York University Grossman School of Medicine, New York, NY.
Laura B ZeiserDepartment of Surgery, New York University Grossman School of Medicine, New York, NY.
Dorry L SegevDepartment of Surgery, New York University Grossman School of Medicine, New York, NY.
Mara A McAdams-DeMarcoDepartment of Surgery, New York University Grossman School of Medicine, New York, NY.ORCID https://orcid.org/0000-0003-3013-925X
New York University · USUniversity Medical Center Groningen · NL

Funding

Structural Racism, Resilience, and Premature Cognitive Aging in End-Stage Renal Disease - Revision - 5R01AG077888 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Mara A. McAdams DeMarco · 2022 to 2026
$4.4M
Kidney transplantation in older, frail and cognitively impaired adults with ESRD: Balancing utility vs. justiceR01AG055781 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2017 to 2021
$4.2M
Hemodialysis-based interventions to preserve cognitive functionR01DK114074 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2018 to 2022
$3.9M
Developing personalized immunosuppression for older kidney transplant recipientsR01DK120518 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2019 to 2022
$2.7M
Patient Oriented Research in Solid Organ TransplantationK24AI144954 · NIAID · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI SEGEV, DORRY L. · 2020 to 2024
$956k
Impact of climate change on cognitive and physical aging of older kidney transplant recipientsK02AG076883 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Mara A. McAdams DeMarco · 2023 to 2026
$728k
NIAID NIH HHS K24 AI144954NIA NIH HHS K02 AG076883NIA NIH HHS R01 AG055781NIA NIH HHS R01 AG077888NIDDK NIH HHS R01 DK114074NIDDK NIH HHS R01 DK120518
6 · The paper itself

Abstract

Background: Advancements in medical technology, healthcare delivery, and organ allocation resulted in improved patient/graft survival for older (age ≥65) kidney transplant (KT) recipients. However, the recent trends in these post-KT outcomes are uncertain in light of the mounting burden of cardiovascular disease, changing kidney allocation policies, heterogeneity in candidates' risk profile, and the coronavirus disease 2019 pandemic. Thus, we examined secular trends in post-KT outcomes among older and younger KT recipients over the last 3 decades. Methods: We identified 73 078 older and 378 800 younger adult (aged 18-64) recipients using Scientific Registry of Transplant Recipients (1990-2022). KTs were grouped into 6 prepandemic eras and 1 postpandemic-onset era. Kaplan-Meier and Cox proportional hazards models were used to examine temporal trends in post-KT mortality and death-censored graft failure. Results: From 1990 to 2022, a 19-fold increase in the proportion of older KT recipients was observed compared to a 2-fold increase in younger adults despite a slight decline in the absolute number of older recipients in 2020. The mortality risk for older recipients between 2015 and March 14, 2020, was 39% (adjusted hazard ratio [aHR] = 0.61, 95% confidence interval [CI], 0.50-0.75) lower compared to 1990-1994, whereas that for younger adults was 47% lower (aHR = 0.53, 95% CI, 0.48-0.59). However, mortality risk during the pandemic was 25% lower (aHR = 0.75, 95% CI, 0.61-0.93) in older adults and 37% lower in younger adults (aHR = 0.63, 95% CI, 0.56-0.70) relative to 1990-1994. For both populations, the risk of graft failure declined over time and was unaffected during the pandemic relative to the preceding period. Conclusions: The steady improvements in 5-y mortality and graft survival were disrupted during the pandemic, particularly among older adults. Specifically, mortality among older adults reflected rates seen 20 y prior.

Identifiers

PMID37928483
PMCPMC10624464
OpenAlexW4388210714

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Registered trials

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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.