Long-Term Results of Kidney Transplantation in Patients Aged 60 Years and Older

<b>Background/Objectives:</b> The results of kidney transplantation (KTx) in elderly patients are deteriorated by more frequent use of organs procured from older or extended criteria donors (ECDs). To eliminate the influence of donor factors on the transplantation results, the pair analysis method was applied. The study aimed to assess the survival, during long-term follow-up after transplantation, of recipients and transplanted kidneys, graft function, and factors influencing survival in recipients aged 60 years and older (≥60) compared to recipients aged less than 60 years (<60) who received a kidney from the same brain death donor (DBD). <b>Methods:</b> The study group consisted of 213 consecutive patients ≥60 who received a kidney procured from a DBD from whom the second procured kidney was transplanted to a patient <60 (control group). <b>Results:</b> The survival rates in the 10-year follow-up period were lower in those recipients ≥60 than in the control group (<i>p</i> < 0.01). The survival rates of the transplanted kidneys were comparable in both groups, while the death-censored graft survival was higher in those patients ≥60 than in the control group (<i>p</i> < 0.05). The estimated glomerular filtration rate levels were similar in the follow-up in patients ≥60 compared to those recipients <60. Transplantation of kidneys procured from ECD, longer duration of dialysis treatment, and longer duration of cold ischemia time (CIT) affected the recipient and graft survival in the ≥60 patients. Death-censored kidney graft survival was influenced by transplantation of a kidney procured from ECD, longer CIT, and the need for reoperation in the early postoperative period. <b>Conclusions</b>: Despite the higher mortality in the kidney recipients ≥60, the long-term results of KTx after the elimination of donor-dependent factors are similar or better compared to the recipients <60. The factors influencing the results of KTx in elderly recipients differ from those observed in the entire cohort and younger patients.