Introduction: Increased patient survival  and technological advances in renal replacement therapy, have resulted in patients over 70 years of age forming a significant cohort of patients listed for kidney transplantation. The study aims to analyse recipient profiles and clinical outcomes after kidney transplantation in recipients over the age of 70 in a single centre and compare it to recipients under 70 years as reported in literature.
Methods: We performed a single centre retrospective analysis reviewing kidney transplant recipients aged ≥70 years between February 2013 and Feb 2023, across a spectrum of clinical characteristics and transplant outcomes. Data was analysed using SPSS.
Results: Total of 2580 transplants were done at Manchester Royal Infirmary during this period.The over 70 cohort, comprised of 256 patients. Of this group 249 (97.3%) underwent kidney transplant alone, 6 (2.3%) SIK and one a dual kidney transplant. Donors for this cohort included 120 DBD donors, 103 DCD donors and 33 living donors. The mean age of recipients was 73.8 years(SD+/-2 yr7mon) with oldest recipient being 81.5yrs. One third of the cohort (n=86) were pre-emptively transplanted. The BMI was 27.9 (19-39)kg/m2. Diabetes Mellitus (16%), hypertension (14.5%) and glomerulonephritis (12.5%) were the most common primary diseases causing ESRD.  Postoperatively 12 patients (4.7%) required re-exploration within 7 days for various indications.  84 patients (32%) had delayed graft function. Five patients (1.9%) had primary non function. Eighty-two recipients (32%) were admitted within 1 year of transplant, with UTI (n=27) being most common cause, followed by decreased renal function (n=13) and CMV viremia (n=6). 24 (9.3% ) patients died within 1 year of transplant. Twenty patients (7.8%) had graft loss within 1 year of transplant
Conclusion: This single centre 10-year analysis demonstrates that readmission ,primary non function  and graft survival rates in recipients over 70 years of age are comparable to transplantation in recipients below the age of 70. To the best of our knowledge this is one of the largest experiences with transplanting the over 70s in the UK. Detailed long-term evaluation of the cohort will be required to assess overall survival and quality of life benefits post-transplant. This will help in better risk stratification and patient selection for transplantation in this cohort.