ArticleJournal of transplantation2025
Older Kidney Transplant Patients Are Over Immunosuppressed Using Standard Protocols With Differential Sex-Based Complications.
Article in Journal of transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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Who cites it
3 citing papers in PubMed.
- Peritoneal Dialysis-Related Peritonitis and Kidney Transplant Outcomes.JAMA network open · 2026Article
- Sex Differences in Alloimmunity and Other Immunological Considerations in Organ Transplantation.Immunological reviews · 2026Review
- Age-specific impact of different immunosuppressive regimens on kidney transplant outcomes: clinical evidence from the scientific registry of transplant recipients.Frontiers in nephrology · 2026Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Increasing numbers of older patients are undergoing kidney transplantation. While there is evidence for both sex- and age-related immunological variations increasing the risks of immunosuppression (IS), few centers enforce age- or sex-specific IS adjustments. Methods: We investigated outcomes of 148 kidney transplants performed in our center between April 2009 and March 2019 in recipients aged > 60 years and compared them to outcomes in 272 younger recipients (divided into age groups 18-34, 35-49, and 50-60 years), matched for degree of human leukocyte antigen (HLA) sensitization (calculated reaction frequency, cRF), number of donor-recipient HLA mismatches, and cytomegalovirus (CMV) serostatus, all treated with the same IS protocol. Outcomes were time to (i) first episode of biopsy-proven acute rejection (BPAR), (ii) first CMV viremia within the first 6 months, (iii) incidence of any new-onset malignancy, and (iv) development of donor-specific anti-HLA antibodies (DSAs). Results: Overall rates of BPAR were highest in the recipients under the age of 35, but with no evidence of a difference between older age groups. Conversely, the risk of CMV viremia and malignancy was significantly higher in older recipients; in the > 60-year-old group, CMV viremia HR: 2.66 (95% CI: 1.49-4.75), and malignancy HR: 7.3 (95% CI: 1.7-31.10) versus the youngest group with little evidence was confounded by comorbidity or donor factors on multivariate analysis. The risk of CMV infection was most marked in the oldest female group, while the risk of malignancy was greatest in older males. The development of DSA was equal across all age groups. Conclusion: Our data indicate that older recipient age is associated with increased risk of CMV viremia and malignancy after transplantation, suggesting an age-associated vulnerability to IS, with the risk occurring mostly in older women and older men, respectively. These data support the need to develop age- and sex-specific protocol adjustments.
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