ArticleJornal brasileiro de nefrologia
Elderly kidney transplant recipients: efficacy and risks of a conservative immunosuppression regimen.
Article in Jornal brasileiro de nefrologia. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionOver the past decade, there has been an increase in renal transplantation among the elderly. However, age-related declines in immune function heighten the risks associated with immunosuppressive therapy, impacting patient survival. This study examines the first year's immunosuppressive regimen post-kidney transplantation in elderly individuals. METHODOLOGY: A singlecenter retrospective cross-sectional study was conducted, categorizing kidney transplant recipients from January 2013 to December 2017 into two groups: a control group (aged 30-50 years) and a seniors group (over 60 years).
resultsThe study included 59 seniors and 114 controls. Seniorsreceived lower mycophenolate doses (11 ± 7.7 mg/kg/day) compared to controls (15 ± 7.2 mg/kg/day; p = 0.003) and fewer corticosteroids were administered (64.9% vs. 18.6%; p = 0.0001) as maintenance immunosuppression. Seniors also had a higher tacrolimus level-to-dose ratio (p < 0.05). Additionally, seniors experienced more leukopenia (56.5% vs. 35.6%; p = 0.017) and cytomegalovirus infections (44.7% vs. 26.9%; p = 0.034).
conclusionDespite receiving lower mycophenolate doses and fewer corticosteroids along with a higher tacrolimus level-to-dose ratio, seniors had more adverse events. However, graft survival was not affected. These results suggest that elderly patients may benefit from reduced immunosuppressant exposure, supporting a conservative approach.
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