Decrease in survival benefits with age in expanded criteria donor kidney transplant recipients, especially those with CVD
By Elana Gotkine HealthDay Reporter
TUESDAY, June 10, 2025 (HealthDay News) — Transplantation with standard-criteria kidney offers a clear survival benefit, but this decreases with age and for those with a history of cardiovascular disease (CVD), according to a study presented at the annual congress of the European Renal Association, held from June 4 to 7 in Vienna.
Rachel Hellemans, M.D., Ph.D., from Antwerp University Hospital in Belgium, and colleagues examined the survival benefit of deceased donor kidney transplantation compared with continued dialysis in waitlisted patients with kidney failure. Data were included for 64,013 patients aged ≥20 years from the European Renal Association Registry database who were on dialysis while waitlisted for a first deceased donor kidney-only transplant.
Overall, 40,441 patients received a kidney transplant, either from a standard criteria donor (SCD)/donation after brain death (DBD), SCD/donation after circulatory death (DCD), expanded criteria donor (ECD)/DBD, or ECD/DCD (45.0, 12.1, 35.2, and 7.7 percent, respectively). The researchers found that higher five-year survival was seen in SCD transplant recipients versus dialysis patients. There was a decrease in survival benefits seen with age in ECD kidney transplant recipients, especially in recipients of DCD kidneys and recipients with CVD comorbidity: five-year survival was 57 and 58 percent for a 75-year-old ECD/DCD recipient or a 75-year-old ECD recipient with CVD, respectively, compared with 54 percent among patients continuing dialysis. In the oldest patients, early posttransplant mortality contributed to the reduced benefit.
“We found that transplantation with standard-criteria kidneys still offers a clear survival benefit at virtually every age, but in the oldest, most comorbid recipients receiving lower-quality organs, that edge can all but disappear,” Hellemans said in a statement.
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