Resumen

BORROTO DIAZ, Gerardo et al. Kidney transplant. Rev cubana med [online]. 2008, vol.47, n.3. ISSN 0034-7523.

Kidney tansplant in patients aged 60 and over is a challenge for the pofessionals devoted to tansplantology and, on occasions, there is a certain resistance to its implementation fearing a worse result. Objectives: to know the conditions sorrounding kidney transplant in our environment among patients aged 60 and over, the main complications existing in the immediate trasplant, the survival of the graft and of the sick individual and the fundamental causes of treatment failure compared with the results obtained in younger patients Methods: A case-descriptive, retrospective and longitudinal study was conducted. The information was taken from the kidney transplant register of the Nephrology Service of "Hermanos Ameijeiras" Hospital. The universe consisted of the patients over 18 that underwent kidney transplant at the institution from 1984 to April 30, 2008. Retransplants and combined transplants were excluded. The sample was divided into two groups: Group I, patients aged 60 and over, and Group II or controls, patients aged 18-59. The results were compared looking for differences among the main complications of the immediate posttransplant, the causes of loss of grafts and patients, and the graft survival. Results: The total number of kidney transplants performed in patients aged 60 or over only accounted for 5.5 % in the series, whereas the living donor accounted for 6.9 %. The elderly patients had a lower rejection rate (31 vs. 50.1%, p = 0.0042) and more vascular complications (17.1 vs. 6 %, p = 0.003), less sick subjects with function on discharge, but in those who were discharged with function, the figures of creatinemia were lower. In group I. The death of the patient with functioning graft, 62.5 % and the vascular complication, 20.8 %, were the main causes of loss of grafts. Heart diseases, 66.7 %, were the chief cause of death. On comparing the survival between both groups, it proved to be better in younger patients, p = 0.0028, but on studying the patients dying with functioning graft, no statistical differences were observed. Conclusions: By carrying out an adequate study of the patients, individualizing the immunosuppressive therapeutics and reducing the times of ischemia, the kidney transplant may be a valid theapeutic option for patients over 60.

Palabras clave : Kidney transplant; elderly recipient; dead donor.

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