Does the risk of acute rejection really decrease with increasing recipient age?

Abstract

In corneal transplants the risks of acute rejection and graft failure decrease with increasing recipient age, but kidney graft survival analyses tend to show the opposite effect. Why is this? Cadaveric kidney transplants performed in the UK and Republic of Ireland between 1985 and 1993 (UKTSSA database) were analysed by multifactorial methods to identify major factors affecting graft survival. In a study database that had been censured for technical failure and death with a functioning transplant, it was shown that increasing recipient age was associated with decreasing risk of graft failure at 1 year. This is consistent with the view that kidney transplants, like corneal transplants, are less likely to be acutely rejected as the age of the recipient increases.

Early liver retransplantation in adults

“…That concept is supported by reports in the literature of the lower rate of acute rejection in older patients . Moreover, according to death‐censored data in kidney transplant recipients, short‐term graft survival rates increase with increasing age . We found similar trends for retransplantation within the first year: In that high‐risk period, recipient age from 30 to 40 and recipient age from 18 to 30 were the dominant risk factors for retransplantation.…”

Pharmacodynamic Monitoring of Cyclosporin A Reveals Risk of Opportunistic Infections and Malignancies in Renal Transplant Recipients 65 Years and Older

“…In several reports, acute and chronic rejections have been reported to be less frequent in older recipients. 23 In contrast, increased recipient age was assessed as an independent risk factor for the development of acute and chronic allograft rejection. 24,25 Published clinical data on ageadapted immunosuppressive protocols are conflicting.…”

“…Their median age was 70 years (65-77), and body mass index was 25 kg/m 2 (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) …”